LYNDALE HEAD START

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

Type A citation - immediate risk to health, safety, or personal rights

Type A citation - immediate risk to health, safety, or personal rights

Type B citation - potential risk if not corrected

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 12/18/2025, at 8:50 AM, Licensing Program Analyst (LPA) Liridon Fici- Doni conducted an unannounced Case Management visit regarding an incident that occurred on 12/12/2025 and met with Born, Roopali- Director and informed her the purpose of today's visit. LPA observed 28 children in care. During today's visit, LPA obtained copies of children's roster for 12/12/2025 and current children's roster for 12/18/2025 and interviewed three (3) children and director. On 12/12/2025, the Director stated she was in her office when Staff 2 (S2) informed her that Child 1 (C1) had diarrhea and did not have extra clothing. The Director contacted the parents to request additional clothing along with leaving a voice message. The Director made the call herself so that S2 could continue supervising the children. C1 and S2 later went outside. The Director attempted to contact the parents; however, there was no answer. Director stated that, in the meantime, she went next door to check for extra clothing, but none was available. The Director also checked the playhouse and did not find any clothing to provide for the child. The Director then planned to go to Target to purchase clothing for C1. While walking toward the front door, the Director was informed by Staff 3 (S3) after C1 went home that C1’s parent had observed C1 playing outside in underwear and was upset. The Director returned to the classroom and observed C1’s parent present with extra clothing for the child. The parent informed the Director that she was upset that C1 had been outside wearing only underwear. The Director stated she was not aware that C1 had been taken outside without clothing. The parent expressed continued concern and decided to take C1 home. Continue on page 1 of 2. NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Liridon Fici LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025 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 4 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 a