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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846373
Report Date: 04/10/2026
Date Signed: 04/10/2026 12:10:41 PM

Document Has Been Signed on 04/10/2026 12:10 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:EASTER SEALS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
364846373
ADMINISTRATOR/
DIRECTOR:		ESTELA PEREZFACILITY TYPE:
850
ADDRESS:1102 WEST PHILLIPS STREETTELEPHONE:
(909) 981-4668
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 110TOTAL ENROLLED CHILDREN: 48CENSUS: 40DATE:
04/10/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Estela Perez, site director TIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Aman Lama arrived at the facility to investigate a self-reported Unusual Incident Report (UIR) reported to the department on 04/02/2026. LPA was granted access to the facility by facility representative, Estela Perez. LPA discussed the purpose of today’s inspection, toured the facility, took census and then met with the facility representative to further discuss the incident. LPA gathered information and conducted interviews.

On 04/02/26, it was reported that at approximately 4:30pm on 04/01/26, Child 1 (C1) and teachers went outside to the playground. At some point between 5:00pm-5:10pm, C1 entered the classroom by themselves. At approximately 5:13pm, C1 was observed by a staff, in the classroom actively engaged in play.

Based on the information gathered, the following violations have been identified: C1 was left without any visual observation from any staff, resulting in an absence of supervision. California Code of Regulations Section 101229(a)(1) has not been followed and is being cited. SEE LIC809D for cited deficiencies.

A civil penalty has been assessed during this inspection because of the absence of supervision of C1, in the amount of $500. See LIC809D and LIC421IM for more details. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

SEE LIC809C for a continuation of this report.

NAME OF LICENSING PROGRAM MANAGER: Gilbert Sena
NAME OF LICENSING PROGRAM ANALYST: Aman Lama
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2026
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.

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: EASTER SEALS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 364846373
VISIT DATE: 04/10/2026
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LPA Aman Lama informed facility representative, Estela Perez that this report dated 04/10/2026 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Aman Lama informed the facility representative Estela Perez to provide a copy of this licensing report dated 04/10/2026 that documents any Type A citation(s) to parents of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given to facility representative, Estela Perez and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to facility representative Estela Perez
NAME OF LICENSING PROGRAM MANAGER: Gilbert Sena
NAME OF LICENSING PROGRAM ANALYST: Aman Lama
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/10/2026 12:10 PM - It Cannot Be Edited


Created By: Aman Lama On 04/10/2026 at 10:35 AM
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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: EASTER SEALS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 364846373

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/13/2026
Section Cited
CCR
101229(a)(1)

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(a)...(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by: Based on the self-reported incident, it was admitted that a
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During todays visit, facility representative was able to share staff had training for Supervision. Facility is asked to submit proof of the training agenda along with staff names and signatures of those who attended.
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child, C1, was left in a classroom without the supervision of a teacher. This poses an immediate health, safety and personal rights risk to all children in care.
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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.
Gilbert Sena
NAME OF LICENSING PROGRAM MANAGER:
Aman Lama
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2026


LIC809 (FAS) - (06/04)
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