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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191200980
Report Date: 09/02/2026
Date Signed: 09/02/2026 01:42:05 PM

Document Has Been Signed on 09/02/2026 01:42 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOLFACILITY NUMBER:
191200980
ADMINISTRATOR/
DIRECTOR:		VIVIEN FIRTAFACILITY TYPE:
850
ADDRESS:700 NORTH GLENOAKSTELEPHONE:
(818) 848-3233
CITY:BURBANKSTATE: CAZIP CODE:
91502
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: DATE:
09/02/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:11 AM
MET WITH:Kristina Balos, DirectorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 9/2/2026 at 09:11 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced Required 3-Year Inspection. The facility is located at 700 North Glenoaks, Burbank, CA 91502. LPA identified self, reason for the visit, and met with Kristina Balos, Director.

Facility Representative Kristina Balos, Director allowed entry into the facility and provided LPA with a guided tour of inside and outside of the facility. The facility is currently licensed for a capacity of 75, per FR they currently have 66 enrolled. The facility’s hours of operation are Monday through Friday from 09:00 AM to 01:00 PM.

Required postings were observed and posted in the Office and front windows of office of the facility.

The facility is made up of five (5) classrooms; Classroom #1, ages 4 ½ years- 5 years with two (2) staff, Classroom #2, ages 4 years – 4 1/2 years with two (2) staff, Classroom #3, ages 3 ½ years-4 years with two (2) staff, Classroom #4 3 ½ years-4 years with two staff, and Classroom #5, ages 3 years – 3 ½ years with two (2) staff. In addition, there were two (2) Floater Teachers and one (1) Aide available during this inspection.

LPA toured the classrooms. LPA observed in all the classrooms, the furniture, toys, and equipment were maintained in good condition, free of sharp, loose or pointed parts and were appropriate for the ages of the children. The floors have a surface that is safe and clean. There are individual cubbies for each child to store
their personal items. There is drinking readily available with the use of water filtered pitchers located in
Page 1 of 4
Rita Ramos
Elicia Calvillo
DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2026
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOL
FACILITY NUMBER: 191200980
VISIT DATE: 09/02/2026
NARRATIVE
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each classroom, and the facility provides one time use plastic cups and paper cups for individual use when children are drinking water. LPA observed first aid kits located in all the classrooms and an inventory was conducted for necessary supplies. LPA observed devices on the walls, FR confirmed it was carbon monoxide detectors and fire pull alarms were on the facility walls. Per FR, teachers use water and soap to clean tables, and during the hours of operations the cleaning products are inaccessible to children and stored in locked cabinets or stored on high shelves in each classroom.

LPA did observe that the food preparation areas are in each classroom. Per FR meals are provided by the parents and the facility provides snacks. The food preparation areas have a mini refrigerator in each classroom. LPA did not observe any open containers in the refrigerator and snacks and water are stored in the refrigerators. Food preparation was inspected for safety and sanitation, hazardous items including poisonous cleaning compounds were stored inaccessible to children on high shelves or locked cabinets.

Classrooms #1, #2, #3, and #4 share a girls and boys restroom located near Classroom #4 and Classroom #5 has a restroom located in the classroom. LPA observed there are toilets, sinks, and paper products available.

Fire and Disaster Drill documentation was available, and the last drill was conducted on 04/10/2026. LPA reviewed the facilities Fire and Disaster written action plan. Per FR, isolation area for sick children in the Office. Hazardous items including poisonous cleaning compounds were stored inaccessible to children. There are a telephone service, heating, lighting and ventilation were evaluated for safety and comfort.

LPA toured the Big Yard and Sand Yard outdoor play areas and LPA observed that both outdoor play areas were in a safe condition, free of sharp, loose, or pointed parts, in good repair and age appropriate. The surfaces of the outdoor activity space are sand, cement, artificial grass, and rubber material, are maintained in a safe condition and free of hazards. There is adequate shade in the outdoor play area with the use of trees and shade structures. The children have access to pitchers of filtered water and disposable cups for drinking water during outdoor play. There is a climbing structure in the Big Yard and Sand Yard outdoor play areas with sand and rubber material under and surrounding the structure to absorb falls. LPA advised that no
children shall be left without supervision at any time. There is no swimming pool or other bodies of water on
the premises. LPA did observe in Classroom #1 a 10 gallon fish tank.
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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOL
FACILITY NUMBER: 191200980
VISIT DATE: 09/02/2026
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LPA’s inspection of Children’s records was made and required forms were reviewed for completeness and documented on LIC857 for children. LPA’s inspection of Staff records was made and required forms were reviewed for completeness and document on LIC859 for staff. The Pediatric CPR and First Aid card expires on 08/18/2028 for the Director.

LPA observed that teacher-child ratios were maintained, and staff names were recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate. The Daily Activity Schedule included a variety of activities that include but are not limited to quiet and active play, rest and relaxation, eating, and toileting. The Sign-in and out sheets were available upon request, LPA observed 64 of 64 children signed in at the time of arrival for the inspection.

Facility Representative 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 as specified in Health and Safety Code section 1597.16.

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 (Interim Licensing Standards) outlined in PIN 21-21.1-CCP.
LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)
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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BURBANK 1ST UNITED METHODIST CHURCH NURSERY SCHOOL
FACILITY NUMBER: 191200980
VISIT DATE: 09/02/2026
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CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES

There are no infants enrolled at this facility. LPA discussed the safe sleep regulations with Facility Representative 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 Facility Representative of the importance of checking for and removing any 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Facility Representative 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 [email protected]. 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.

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

Exit interview conducted and report was reviewed with Kristina Balos, Director.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
LIC809 (FAS) - (06/04)
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