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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500336
Report Date: 09/24/2026
Date Signed: 09/24/2026 02:23:13 PM

Document Has Been Signed on 09/24/2026 02:23 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:DE ANZA SCHOOL HEAD START/STATE PRESCHOOLFACILITY NUMBER:
191500336
ADMINISTRATOR/
DIRECTOR:		RICARDO RIVERAFACILITY TYPE:
850
ADDRESS:12820 EAST BESS ST.TELEPHONE:
(818) 962-3311
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY: 45TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
09/24/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Education Supervisor Guillermina Solis TIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On Thursday, September 24, 2026 at 12:00 p.m., Licensing Program Analyst (LPA) C. Nguyen conducted an unannounced annual inspection and met with Education Supervisor Guillermina Solis who guided LPA on a tour of the facility. This facility is in the campus of De Anza Elementary School; to enter the facility one must enter through a secured gate on Bess Street which is between the playground structure and bungalows. This is a Head Start program that operates Monday-Friday from 8:00 a.m. to 2:30 p.m. and has two classrooms. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Per Education Supervisor, there are 24 children enrolled. Teacher and child ratio were observed: total of 20 children and 4 staff, Classroom 1: 10 children and 2 staff, Classroom 2: 10 children and 2 staff.

Sign in and out takes place at the main entrance area and were reviewed to make sure that the person who signs the child in and out uses their full legal signature and records the time of the day. Facility uses Child Plus to track attendance. The Education Supervisor stated that no firearms, weapons, poisons or bodies of water are located on the premises and LPA did not observe any of the above-mentioned.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A) Menu (weekly/monthly), Earthquake Preparedness (LIC 9148), Child Passenger System Poster (PUB 269), and Daily Schedule.

LPA entered the classrooms and observed furniture, manipulatives, toys, games, and books made accessible to the children to be age-appropriate and free of sharp, loose, or pointed parts. LPA observed each classroom has a cubby for children to store their personal belongings. Napping equipment (cots) and bedding were inspected for good condition, appropriate storage, and cleanliness.


PAGE 1 OF 4
Katrina Chicote
Caroline Nguyen
DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2026
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: DE ANZA SCHOOL HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 191500336
VISIT DATE: 09/24/2026
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Per Education Supervisor, children take their blankets home to wash weekly or have the option to wash them at the ECE center at an off-site location. Children bring their own water bottles and bottles get refilled as needed via filtered water system. Water jugs are refilled and disposable cups are also available. LPA observed a kitchenette in between both classrooms with a refrigerator and a water dispenser. Licensing staff observed step trash bins with a tight-fitting lid inside the classrooms. All toilets and washing facilities are in safe and sanitary operating conditions. During time of inspection, LPA observed cleaning solutions stored inside cabinet with child-safety locks in the kitchenette which has child-safety doors in place, making the area inaccessible. Education Supervisor stated that they currently do not have any children on medication, but there are children with allergies that do not require medication. Education Supervisor stated the ill isolation area to take place in the quiet corner, separated from other children; the staff restroom will be used for ill children.

Heating, lighting, and ventilation were evaluated by LPA. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostats and temperatures to be between 70-71 degrees. LPA observed the fire extinguishers in the classrooms and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 7/1/2026. Facility has functioning carbon monoxide and smoke detector that meets statutory requirements. The last emergency drill was conducted on 9/22/2026. First aid kit supplies are kept inside the classrooms and observed to be fully equipped.

Licensing staff inspected the outdoor play area and observed the playground yard to be fully fenced around the perimeter. The outdoor play equipment was observed to be free of sharp, lose or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around and/or under climbing equipment have cushioning material to absorb a fall. Drinking water is readily available outdoors. There is adequate shade in the play yard via trees and canopies. There is an outdoor waiver on file.



Per Education Supervisor, the De Anza Elementary School provides meals from the school cafeteria: breakfast, lunch and snack. LPA informed Education Supervisor that any food brought from the children's homes, shall have the container labeled with the child's name and properly stored or refrigerated. LPA observed the facility to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage.

LPA reviewed the children’s roster, children’s files, staff files, and sign in/out sheets and all were observed to be complete. LPA provided consultation regarding staff files.


PAGE 2 OF 4
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC809 (FAS) - (06/04)
Page: 3 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: DE ANZA SCHOOL HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 191500336
VISIT DATE: 09/24/2026
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There is at least one person trained in CPR and Pediatric First Aid present during this inspection. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present had proof of immunization against Pertussis, MMR, and Influenza declination. Education Supervisor was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

All individuals subject to criminal background review have obtained a criminal record clearance. Education 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.

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 on 12/13/2023 in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. LPA referred licensee 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



LPA discussed the safe sleep regulations with licensee 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.

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/.


PAGE 3 OF 4
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DE ANZA SCHOOL HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 191500336
VISIT DATE: 09/24/2026
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Education 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.

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.

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

The Notice of Site Visit (LIC 9213) – A notice of site visit was given and must remain posted for 30 days. Appeal rights were given. Exit interview conducted and report was reviewed with the Education Supervisor Guillermina Solis.






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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC809 (FAS) - (06/04)
Page: 5 of 5