<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010880
Report Date: 10/05/2026
Date Signed: 10/05/2026 01:06:41 PM

Document Has Been Signed on 10/05/2026 01:06 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:MONTROSE PRESCHOOL & INFANT CAREFACILITY NUMBER:
198010880
ADMINISTRATOR/
DIRECTOR:		SHONNA CLARKFACILITY TYPE:
830
ADDRESS:2700 MONTROSE AVENUETELEPHONE:
(818) 249-4048
CITY:MONTROSESTATE: CAZIP CODE:
91020
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 10DATE:
10/05/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Shonna ClarkTIME VISIT/
INSPECTION COMPLETED:
01:30 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 10/05/2026, at 08:40 am, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced annual random inspection. Upon arrival, LPA met with Facility Representative, Shonna Clark, Director, who guided the LPA on a tour of the facility. Child Care Entrance Checklist was provided.

This is an infant program located in the Crescenta Valley United Methodist Church property, which operates Monday through Friday from 07:30AM 6:00PM. There is also preschool program on the premises with facility number 191200283. Programs are physically separated indoors and outdoors.
The infant program consists of 3 classrooms. Per Facility Representative there are 10 infants currently enrolled and only 2 classrooms are in use.
LPA observed all required forms/publications posted by the front entrance for both programs.
LPA toured infant classrooms and observed 4 infants with 2 staff members in older infant room and 3 infants with one staff member in younger infants’ room.
Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded.
All classrooms furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Furniture and equipment are-age appropriate for height and size of infants. All classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials and surfaces accessible to children are toxic free.

Diaper changing area is clean and within arm's length of a sink with running water and dispensable soap. Diaper changing table has a padded surface of no less than one inch thick and is covered with washable vinyl or plastic. Sides are raised at least 3 inches to prevent the infant from rolling off the mat. Soiled diapers are sealed in plastic bags and dispose of in a trash can that is inaccessible to curious infants.

Page 1 of 5

Brandi VanOosten
Shushanik Safaryan
DATE: 10/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2026
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 9
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 9
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: MONTROSE PRESCHOOL & INFANT CARE
FACILITY NUMBER: 198010880
VISIT DATE: 10/05/2026
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
Napping equipment and bedding were inspected for good condition, appropriate storage, and cleanliness. Cribs and mats are used for napping and for younger infants are placed in a room separate from the activity area. Infants able to pull themselves up, sleep on mats.
Cribs are used by younger infants. Mattress is at its lowest position, and side rail cannot be lowered. Mattress is covered with vinyl or similar moisture resistant material. Bedding is replaced when wet or soiled. Per facility representative, facility washes linens daily or as needed.

LPA observed that there are functioning smoke and carbon detectors in the facility. LPA observed a fully charged and serviced fire extinguisher. Emergency disaster drill was last conducted on 03/2026. Facility Representative states there are no weapons, firearms, or bodies of water on the premises.

Per Facility representative, bottles and food are brought from home for younger infants, older infants may eat meals and snacks prepared by the facility. LPA observed labeled trays with infant’s names in the cabinet and refrigerators. Microwave ovens are used for warming up foods while bottles are warmed up in bottle warmers. Facility has a kitchen on premises. LPA toured the kitchen and reviewed snacks if needed. First aid bags are kept in each classroom.

All storage containers for solid waste, including moveable bins, shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors via water pitcher and children bring their own water bottles too. The facility was observed to be free of flies, other insects, and rodents.

The empty room or directors office s are used for ill children. Mat will be available if needed.

Outdoor playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed grass though the yard. A large canopy used to provide shade.



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. Facility uses a program called Pro Care. Staff members keep hard copies of sign in and sign out sheets in the classrooms too.

Page 2 of 5

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2026
LIC809 (FAS) - (06/04)
Page: 3 of 9
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: MONTROSE PRESCHOOL & INFANT CARE
FACILITY NUMBER: 198010880
VISIT DATE: 10/05/2026
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’s Records were reviewed to ensure that Identification and Emergency form and required infant’s needs and service plan are on file. Inspection of required forms was made and documented on LIC 857.

At 12:00pm, LPA observed 7 out of 10 children files were missing LIC 9224 ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS for the type A citation received on 03/26/2026.Per Director statements,LIC 9224 form was not provided to all children`s parents.

LPA reviewed staff records; staff files were complete. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The review of Staff records was documented on LIC 859.

Following regulations were discussed and provided to the Director during this visit.

- 101429. Responsibility for providing care and supervision for infants. There always should be a staff member in the nap room when infant(s) is in the room. When diaper change is conducted in the younger infant’s room, there should be an additional staff member in the room to provide supervision.

-101438.1 Infant Care General Sanitation.

-101438.3- Indoor Activity Space for Infants.

-101430. Infant Care Activities.

-101439.1 Infant Care Center Sleeping Equipment.

-101427. Infant Care Food Service.

Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file. AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

Page 3 of 5

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2026
LIC809 (FAS) - (06/04)
Page: 4 of 9
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: MONTROSE PRESCHOOL & INFANT CARE
FACILITY NUMBER: 198010880
VISIT DATE: 10/05/2026
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
Per Facility representative, at this time IMS services not needed for children enrolled.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

LPA advised the licensee to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.



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-and-resources/safe-sleep as an additional resource.
LPA also informed facility representative 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.
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.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.



Page 4 of 5
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2026
LIC809 (FAS) - (06/04)
Page: 5 of 9
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: MONTROSE PRESCHOOL & INFANT CARE
FACILITY NUMBER: 198010880
VISIT DATE: 10/05/2026
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
For childcare 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 with the Written Directives outlined in PIN 21-21.1-CCP.

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.

Based on the LPA’s observations and records reviews, the following deficiency listed on the attached LIC 809D (Deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that is being cited need to be cleared to protect the children’s health and safety.

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


Exit interview conducted and report was reviewed with facility representative Shonna Clark on 10/05/2026.

Page 5 of 5
NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2026
LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 10/05/2026 01:06 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 10/05/2026 at 12:35 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: MONTROSE PRESCHOOL & INFANT CARE
FACILITY NUMBER: 198010880

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8595

§1596.8595 )c)(4) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b. (4) The licensee shall keep verification of receipt in each child's file.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observations, records review and interview, the licensee did not comply with the section cited above in 7 out of 10 files were missing LIC 9224 form, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/19/2026
Plan of Correction
1
2
3
4
Per Director, parents will be provided with the report dated 03/26/2026 and signed ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS will be collected and filed in children files by POC date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:
Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/05/2026


LIC809 (FAS) - (06/04)
Page: 7 of 9