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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021120
Report Date: 08/28/2026
Date Signed: 08/28/2026 04:40:12 PM

Document Has Been Signed on 08/28/2026 04:40 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:LIGHTED WINDOW PRESCHOOL.FACILITY NUMBER:
198021120
ADMINISTRATOR/
DIRECTOR:		JOHNSON, SUZIEFACILITY TYPE:
830
ADDRESS:1200 FOOTHILL BOULEVARDTELEPHONE:
(818) 590-7785
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 16DATE:
08/28/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:55 AM
MET WITH:Annette ClarkTIME VISIT/
INSPECTION COMPLETED:
04:50 PM
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On 08/28/2026, at 9:00 am, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced case management inspection to investigate the incident reported to the Department by the facility. Upon arrival, LPA was greeted by Assistant Director, Anette Clark, to whom the reason for the visit was explained. Tour was provided. During the tour, LPA observed 16 children present in the facility with 6 staff members.

On 08/24/2026, Facility reported to the Department that on 08/21/2026 at 11:50 am in infant room, Child #1(C1) fell from a highchair after not being properly secured by staff member.

During this inspection, LPA toured the facility, inspected highchair involved in the incident, interviewed staff members, obtain incident report, parent handbook, C1`s nap log, sign in and outs for children and staff present on the date of the incident.

Based on the information provided and interviews, there were 3 staff members, and 8 children present during the incident.

During the interviews, Staff #1 stated they did not observe the incident, since they were in the kitchen area or going to the kitchen, just heard the thump and observed C1 on the floor next to the highchair and observed C1 crying. Staff#2 stated they did not observe the incident since they were assisting children at the table and had their back towards to the area where highchairs located and staff#1 was at the kitchen area. Per Staff # 2 they turned their head after they heard the noise and observed C1 on their side next to the left side of the highchair and observed C1 was crying. Per staff #3, they placed C1 in the highchair and had their back turned and did not observe how C1 got out of highchair.

Page 1 of 2

Brandi VanOosten
Shushanik Safaryan
DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2026
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: LIGHTED WINDOW PRESCHOOL.
FACILITY NUMBER: 198021120
VISIT DATE: 08/28/2026
NARRATIVE
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Based on the information provided, during the incident the highchair was positioned on the hard-surface floor and the height from the floor to the highchair tray was measured by LPA 2 feet and 5 inches(29 inches).

Based on the interviews and report submitted to the Department, incident happened at 11:50am and parents were notified at 3:36pm, which was confirmed by the parent. Per information submitted, staff reported the incident to Assistant Director at 12:50 pm, when she was back from lunch and it was reported to the Director at 1:19 PM, who contacted the parent at 3:36 PM after the information gathering and investigation.

Based on the information obtained, staff present did not observe the incident and did not see what part of the C1`s body hit the floor.

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

LPA Safaryan informed Facility Representative, Annette Clark that this report dated on 08/28/2026 that document(s) one Type A citation 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 Safaryan informed the facility representative to provide a copy of this licensing report dated 08/28/2026 that documents any Type A citation(s) to parents/guardians 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.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

An exit Interview was conducted, a copy of this report along with Notice of Site visit, Deficiency pages and Appeal Rights were explained and provided to the Facility Representative, Annette Clark on 08/28/2026.

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

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 08/28/2026 04:40 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 08/28/2026 at 02:52 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: LIGHTED WINDOW PRESCHOOL.
FACILITY NUMBER: 198021120

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/31/2026
Section Cited
CCR
101429(a)(1)

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101429 Responsibility for Providing Care and Supervision for Infants.1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement is not met evidenced by:
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Per Facility Representative, primary care for C1 was terminated as of 08/24/2026, safety rules regarding high chairs were created, new high chairs obtained.
Additionally, facility will have meeting regarding active visual supervision. Facility will be refered toTehnical Support Program for additional training.
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Based on the information obtained, C1 fell from the highchair with the height of29 inches on the hard surface and no staff member observed the incident, which poses/posed an immediate health, safety or personal rights risk to persons 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.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2026


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 08/28/2026 04:40 PM - It Cannot Be Edited


Created By: Shushanik Safaryan On 08/28/2026 at 03:04 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: LIGHTED WINDOW PRESCHOOL.
FACILITY NUMBER: 198021120

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/04/2026
Section Cited
CCR
101226(a)

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101226Health-Related Services(a)The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury..
This requirement was not met evidenced by:
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Per Facility Representative, instructions will provided to staff members , how to handle incidents,reporting requirements to chain of command .Plan wil be submeted to LPA and training agenda with staff signatures.
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On 08/21/2026, at 11:50am,C1 fell from the highchiar in the day care. Facility staff did not observe the incident and did not see which part of the child`s body hit the floor. Parents were notified at 3:36pm, which poses/posed a potential health, safety or personal rights risk to persons 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.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2026


LIC809 (FAS) - (06/04)
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