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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021235
Report Date: 04/11/2025
Date Signed: 04/11/2025 04:15:35 PM

Document Has Been Signed on 04/11/2025 04:15 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:MAOF EARLY HEAD START - PICO RIVERAFACILITY NUMBER:
198021235
ADMINISTRATOR/
DIRECTOR:		SONIA GUERREROFACILITY TYPE:
830
ADDRESS:9125 BURKE STREETTELEPHONE:
(562) 949-3189
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 6TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
04/11/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Evelyn Gutierrez, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Annual/Random inspection on 04/11/25 at 02:00 p.m. LPA met with Site Supervisor Evelyn Gutierrez who guided analyst on a tour of the facility. This is an infant program licensed for 06 infants ages birth to 2 years of age. Per the site supervisor, there are 05 infants enrolled. Facility hours of operation is from Monday to Friday, 06:30am-05:15pm. There is a preschool license on site facility #191570991.

All areas identified on the Facility Sketch were inspected. The infant program is located next to the center's preschool program. There is one classroom with a separate nap room. LPA observed in the 03 infants with 02 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded on LIC859. Criminal Record Clearances were reviewed. During this inspection, all children were observed to be under visual supervision of a teacher at all times.

Furniture and equipment were inspected for age appropriateness, good repair, free of sharp, loose, or pointed parts. LPA observed that the changing table meets title 22 regulations. LPA observed that the facility utilizes disposable paper towels. Toys were observed to be safe, and do not have sharp points, edges, splinters and are not made of small parts that can pose a choking hazard. LPA observed sufficient napping equipment (cribs/cots) that meets the requirements of Title 22 regulations. The indoor classroom was inspected to ensure that the floors have a surface that is safe and clean. Currently children are not using the restroom since they are not potty trained. All materials and surfaces accessible to children are toxic free. At this time, the front of the classroom is used as an isolation area.

Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Facility provides bottles, dishes, and/or containers and are labeled with the infant's name. Facility also provides infant formula.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2025
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 5
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)
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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: MAOF EARLY HEAD START - PICO RIVERA
FACILITY NUMBER: 198021235
VISIT DATE: 04/11/2025
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 Facility provides Breakfast, lunch, and snack. The facility has a kitchen that is separate from the infant classroom. LPA observed that the kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. There is drinking water available in the indoor classroom via a water dispenser and a water jug is taken while outdoors. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to infants. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects, and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Per site supervisor, there are no bodies of water on the premises and LPA did not observe any bodies of water during the inspection.

Per site supervisor, there are no weapons or firearms on the premises.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA observed all children present were signed in. Children’s Records were reviewed to ensure that Identification and Emergency form and a Needs and Services Plan are on file.

Staff Records were reviewed to ensure that a health screening report is on file. Infant Teachers files were reviewed to ensure that teachers present are qualified. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. Site supervisor’s Mandated Reporter Training ex: 07/17/26 and Pediatric CPR/FA ex: 02/2026.

SB792 Immunization Requirements for Staff and Employees was discussed. All staff have immunization documentation on file.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed with the site supervisor. Website provided: http://mandatedreporterca.com/. All staff certificates are on file.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
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: MAOF EARLY HEAD START - PICO RIVERA
FACILITY NUMBER: 198021235
VISIT DATE: 04/11/2025
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This facility provides Incidental Medical Services – IMS. LPA reviewed 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/.

LPA discussed the safe sleep regulations with site supervisor 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 the site supervisor 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.

Site supervisor 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.



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-proces.

Site supervisor 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.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:


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.
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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: MAOF EARLY HEAD START - PICO RIVERA
FACILITY NUMBER: 198021235
VISIT DATE: 04/11/2025
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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 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP. The facility does not have sinks used for drinking or food preparation; however, the kitchen in the facility premises and obtained a lead test. LPA observed that there were no lead exceedances.

LPA discussed the past due fees with the site supervisor.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

A notice of site visit was given and must remain posted for 30 days

Exit interview conducted and report was reviewed with the site supervisor Evelyn Gutierrez.

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NAME OF LICENSING PROGRAM MANAGER: Ana Chico
NAME OF LICENSING PROGRAM ANALYST: Veronica Martinez-Garza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC809 (FAS) - (06/04)
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