198021050-8-29-2025-33-CC-SPEY-DKZTMV-20250829145145

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021050
Report Date: 08/29/2025
Date Signed: 08/29/2025 02:52:35 PM

Document Has Been Signed on 08/29/2025 02:52 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:	BELLA VISTA ELEMENTARY		FACILITY NUMBER:	198021050
ADMINISTRATOR/ DIRECTOR:	DANIEL OROSCO		FACILITY TYPE:	830
ADDRESS:	2410 NORTH FINDLAY AVENUE		TELEPHONE:	(323) 721-4335
CITY:	MONTEREY PARK	STATE: CA	ZIP CODE:	91754
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	08/29/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:25 PM
MET WITH:	Martha Vega, Early Head Start Teacher and Vanessa Education Specialist		TIME VISIT/ INSPECTION COMPLETED:	03:20 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On August 29, 2025, Friday, Licensing Program Analysts (LPA) Staicy Perry conducted an unannounced annual inspection. LPA met with Early Head Start Teacher, Martha Vega, who guided the LPA on a tour of the facility. This is an Infant Center with a Toddler option. The licensee prefers to serve children aged 18-36 months. Serving 0 infants and 8 toddler children. This is an Early Head Start Program licensed for 8 children which operates Monday – Friday 8:15 am to 3:15 pm. This is a full day Early Head Start Program which operates on the campus of Bella Vista Elementary School . There are 8 children enrolled in total. Sign in/out takes place electronically through Childplus app on an iPad as well as physical papers to sign. Parents use class Dojo to communicate with the staff. Shortly after Education Specialist Vanessa Guzman arrived and took over the inspection.

Facility is located in a portable classroom on the Bella Vista Elementary School Campus. The following staff was present during this inspection: Early Head Start Room with Staff #1 and Staff #2 present supervising the children napping with 5 toddler children. Staff names were recorded, and teacher and child ratio were observed to be in accordance with Title 22 Regulations.

LPA observed central AC /heater and vents located on the ceiling. LPA observed the thermostat located in classroom and the temperature to be at 72. The fire extinguishers are located in the classroom by the entry exit door and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced December 27, 2025. Smoke detectors and carbon monoxide detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. The last emergency drill was conducted on August 27, 2025.

LPA observed children’s personal items to be in individual bins and cleaning solutions were observed to be stored inside a cabinet making it inaccessible to children. First aid kit supplies are kept inside the classroom and LPA observed the kit to be fully equipped. During this visit, teacher Martha stated that there are no

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 6

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.

LIC809 (FAS) - (09/23)

Page: 2 of 6

Document Has Been Signed on 08/29/2025 02:52 PM - It Cannot Be Edited

Created By: Staicy Perry On 08/29/2025 at 02:32 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: BELLA VISTA ELEMENTARY	FACILITY NUMBER: 198021050
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101439(h)(4)

Infant Care Center Fixtures, Furniture, Equipment and Supplies

(h) Infant changing tables shall: (4) While in use, be placed within arm's reach of a sink. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, interviews and record review, the licensee did not comply with the section cited above in not having the diaper changing station with in arms reach of the sink, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2025
	Plan of Correction
1 2 3 4	Per Education Specialist, a hand washing station to be placed within arms reach of a sink and if that is not purchased prior to the PO date, facility will relocate the diaper chaning station near a sink.

Type B

Section Cited

CCR

101429(a)(2)(B)

Responsibility for Providing Care and Supervision for Infants

(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, interviews and record review, the licensee did not comply with the section cited above ithe facility staff were not documeing the 15 minute safe sleep logs which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2025
	Plan of Correction
1 2 3 4	Per Education Specialist, declarations will be submitted ton LPA of all staffs understanding of Title 22 Regulations regarding safe sleep for infants as well as submit 1 week worth ( September 1st-5th, 2025) of safe sleep log tonLPA Perry by POC date.

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: 08/29/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: BELLA VISTA ELEMENTARY	FACILITY NUMBER: 198021050
	VISIT DATE: 08/29/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

children with medication or severe food allergies. Teacher Martha stated no firearms, weapons, poisons nor bodies of water are in the premises and LPA did not observe any of the above mentioned.

LPA entered the classroom, and children were observed to be napping. LPA did not observe Staff #1 or Staff #2 to be conducting 15-minute safe sleep for the toddlers that were observed by LPA to be napping. Per teacher Martha, they just started doing this about 3 weeks ago and she left the paperwork at the office, which poses a potential risk tonthe health and safety of the children in care. LPA observed sleeping arrangements in form of cots and teacher Martha stated sheets are sent home every Friday to be washed. LPA Perry observed two trash bins with a lid, one for diapers and one for trash. LPA Perry did not observe the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat, which poses a potential risk of the health and safety of the children in care. Per Martha, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with eco clean bleach then let dry then wipe. LPA observed children’s personal items to be in individual cubbies.

LPA Perry discussed the safe sleep regulations with teacher Martha 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. The teacher understood.

All furniture and equipment were inspected and was observed to be in good repair, free of sharp, loose, or pointed parts. All toilets and washing facilities are in safe and sanitary operating conditions. Currently, the science area is used as an isolation area.

LPA Perry observed the playground to be fenced all around. The equipment was observed to be in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed play equipment to be age appropriate and areas around or under climbing equipment, are cushioned with material that may absorb a fall. For adequate shade, a large canopy was observed. For outdoor water drinking, staff bring out water jugs and cups for the children.

This program provides breakfast, lunch and p.m. snack. Meals and snacks are provided by the school cafeteria. For indoor water drinking, water jugs are available in the classroom. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin. Storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

All staff present are trained in CPR and Pediatric First Aid present during this inspection. All staff have received an active criminal record clearance as a condition of their employment with the Montebello Unified

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: BELLA VISTA ELEMENTARY	FACILITY NUMBER: 198021050
	VISIT DATE: 08/29/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

School District. Children’s files were reviewed electronically and observed to be complete. LPA observed staff files as well and were reviewed and were observed to be complete.

Teacher Martha 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) 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. Lead testing was completed on 6/7/24 and was found to not have any lead exceedances.

This facility currently does not provide Incidental Medical Services due to no children needing medication. 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/.

MyChildCarePlan.org, Teacher Martha 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.

LPA also informed teacher Martha 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

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: BELLA VISTA ELEMENTARY	FACILITY NUMBER: 198021050
	VISIT DATE: 08/29/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Currently the facility is not in compliance with all Title 22 regulations and is being cited two (2) Type B deficiencies. The deficiencies listed on the following page was observed by LPA Perry and is being cited in accordance with California Code of Regulations Title 22 or the Health and Safety code. 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 Teacher Martha Vega. Appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC809 (FAS) - (06/04)

Page: 6 of 6