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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500278
Report Date: 12/12/2019
Date Signed: 12/12/2019 10:34:08 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SANCHEZ HEAD STARTFACILITY NUMBER:
191500278
ADMINISTRATOR:CAROLYN WONGFACILITY TYPE:
850
ADDRESS:8470 E. FERN AVETELEPHONE:
(626) 927-5790
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY:18CENSUS: 12DATE:
12/12/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Ufuoma Egbikuadje, Early Care and Education Program ManagerTIME COMPLETED:
09:15 AM
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Licensing Program Analyst (LPA) Lissete Gonzalez conducted an unannounced Case Management inspection to conclude the investigation for an incident that was reported to the Department on 10/07/2019. Upon arrival, LPA met with Ufuoma Egbikuadje, Early Care and Education Program Manager. Census was taken.

On 10/07/2019, an incident was reported to the Department via fax where a parent alleged that a child's personal rights were violated while in care. During the investigation, LPA interviewed staff and children, reviewed records, and documentation. Based on the information obtained, LPA determined there is not a preponderance of evidence to substantiate the reported allegation.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with Ufuoma Egbikuadje, Early Care and Education Program Manager.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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