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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020972
Report Date: 05/02/2025
Date Signed: 05/02/2025 01:05:26 PM

Document Has Been Signed on 05/02/2025 01:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BLOSSOM GARDEN LEARNING ACADEMYFACILITY NUMBER:
198020972
ADMINISTRATOR/
DIRECTOR:		MEGHA SAHNIFACILITY TYPE:
830
ADDRESS:101 S. ATLANTIC BLVDTELEPHONE:
(626) 627-2318
CITY:ALHMABRASTATE: CAZIP CODE:
91801
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
05/02/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Stephanie Rodriguez, Assistant DirectorTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On Friday, May 2, 2025, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced annual inspection and met with Assistant Director Stephanie Rodriguez who guided LPA Perry on a tour of the facility. Shortly after Director Megna Sahni arrived and took over the inspection. Census was taken and LPA observed 8 infants in care. This is an infant program that serves children ages 0 to 2 years with a capacity of 10 infants. This program is part of a combination center with a preschool license #198020970. This program operates Monday to Friday 7:30 a.m. – 5:30 p.m. Sign in and out takes place at the main entrance area. Teacher and child ratio were observed, and present staff are fingerprinted cleared and at least one person present who is trained in pediatric first aid/CPR is present.

LPA entered the infant classroom. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cleaning solutions stored inside the top cabinet making it inaccessible for children to reach. LPA observed the cribs to be free from bumper pads, pillows, toys, blankets, hanging above items. LPA Perry observed two step trash bins with a lid, one for diapers and one for trash. LPA observed the diapering changing table and a hand washing sink available when in use and a vinyl diapering mat. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with bleach and water. LPA observed children’s personal items to be in individual bins. LPA also observed infant bottles and food to be labeled with names and dated 5/2/2025 inside the fridge in their own individual bins.



Heating, lighting and ventilation were evaluated by LPA Perry. LPA observed central AC /heater and vents located on the ceiling. LPA observed the thermostats located in classroom and the temperature to be at 72. LPA observed the fire extinguishers located in hallways and the valve on the required 2A10BC fire
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020972
VISIT DATE: 05/02/2025
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extinguishers indicating fully charged and serviced on 5/5/2024. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. The carbon monoxide detector was observed and per director they are operable. The last emergency drill was conducted on 3/19/2025.

For the walking infants, LPA observed sleeping mats to be in good condition. First aid kits supplies are kept inside the classrooms and LPA observed the kits to be fully equipped with band aids, gauzes, adhesive bandages, and antiseptic wipes. During this visit, director stated currently has children with medication or severe food allergies. LPA Perry did not observe the child’s medication to be properly labeled and maintained in its original packaging, as required by Title 22, California Code of Regulations which poses a potential risk to the health and safety of children in care. A doctor’s form was available for departmental review; however, LPA was unable to clearly read the physician’s notes and instructions regarding the use of the prescribed medications. LPA also had director read and was also having difficulty in interpreting the note, including guidance on how and when the medications should be administered. LPA Perry reviewed parent handbook related to medication policies and procedures and did see that the facility does indicate that,” All medication, prescription or non-prescription, must be in the original container with the child’s name and indicated dosage as prescribed by the physician”.

LPA Perry asked if there were any poisons, firearms, weapons or bodies of water. The director stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Director stated the ill isolation area takes place in the director’s office and children utilize the staff restroom. Lead testing was conducted on 2/23/23 and no lead exceedance.

LPA Perry entered the outdoor play area. LPA Perry observed the playground to be fenced all around. LPA Perry observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. LPA Perry observed play structure equipment to be age appropriate and areas around or under climbing equipment, are cushioned with granulated rubber mat that may absorb a fall. For adequate shade, LPA Perry observed shade structure. LPA observed a trash bin with a lid. For outdoor water drinking, staff bring out water pitchers and children sippy cups. Per director playground is getting a deep cleaning and addition of toys so currently the children are doing indoor movements.

This program provides a.m snack, two p.m. snacks. Lunch is provided by the parents. Meals and snacks are prepared onsite. LPA Perry informed director that any food brought from the children's homes, the container

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020972
VISIT DATE: 05/02/2025
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shall be labeled with the child's name and properly stored or refrigerated. For water drinking, LPA Perry observed water pitchers, bottles and sippy cups in the classrooms. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including movable bins with tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects and rodents.

The following documents were posted in a prominent, publicly area front lobby: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and PUB 269 Child Passenger System Poster, and Daily Schedule. Lead results were also observed to be posted. LPA Perry reviewed the children’s roster, children’s files, staff files, 15-minute sleep logs, infant and needs plan and sign in/out sheets and observed all signed in signatures.

LPA Perry observed director Pediatric First Aid/CPR certification from American Heart Association dated 1/2027, Preventative Health and Safety with nutrition and lead component dated 5/23/24 and has proof of immunization against Pertussis, MMR and Influenza declination. Director has completed the mandated reporter (AB 1207) training expires 6/7/2025. Director was advised that the mandated reporter training must be completed every 2 years and is available at www.mandatedreporterca.com. CCLD orientation is on file and dated September 5, 2020.


The following was also discussed with director:
1. The following items are zero tolerance by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020972
VISIT DATE: 05/02/2025
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4.LIC 125 Entrance Checklist provided, and LPA informed that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review.

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

10. Staff Records: must be available for review; background clearance, LIC 503 Health Screening report, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, Staff Qualifications, LIC 9050 Employee Rights, LIC 501 Personnel Record, AB 1207 Mandated Child Abuse Certification, MMR, TDAP, TB, influenza or influenza declination.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs)

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020972
VISIT DATE: 05/02/2025
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constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA Perry discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA Perry eviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020972
VISIT DATE: 05/02/2025
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Currently the facility is not in compliance with Title 22 regulations. The deficiency listed on the following page was observed by LPA Perry and is being cited in accordance with California Code of Regulations Title 22. One type B deficiency is being issued today for regulation. Please see attached LIC 809-D for citation.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview conducted and report was reviewed with director Megha Sahni. Appeal Rights have been provided and discussed.
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/02/2025 01:05 PM - It Cannot Be Edited


Created By: Staicy Perry On 05/02/2025 at 12:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BLOSSOM GARDEN LEARNING ACADEMY
FACILITY NUMBER: 198020972

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(1)(B)
Health-Related Services
(1) All prescription and nonprescription medications shall be centrally stored in accordance with the requirements specified below: (B) Each container shall have an unaltered label.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 2 children's medication was not observed to be properly labeled and maintained in its original packaging, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2025
Plan of Correction
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During inspection LPA did observe facility director call parents to inform the what was needed for the medication. Megna will also review title 22 regulations on medicaions and prvide LPA with a brief summary of what she learned. Director will submit photo of medication in its original packaging and email to LPA by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Staicy Perry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2025


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