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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500278
Report Date: 10/29/2019
Date Signed: 10/29/2019 11:59:31 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: 11DATE:
10/29/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:51 AM
MET WITH:Millie Lim WongTIME COMPLETED:
12:13 PM
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Licensing Program Analyst (LPA) Lissete Gonzalez conducted an unannounced Case Management Inspection due to an incident of ongoing occurrences that were reported to the Department 10/07/2019. LPA met with Head Teacher, Millie Lim Wong. Census was taken.

On 10/07/2019, an incident was reported to the Department via fax where a parent alleges that child's personal rights were violated while in care. The purpose of the inspection was to obtain additional information regarding the allegations reported to the department. During the inspection, LPA conducted interviews and reviewed documentation. LPA was unable to complete interviews with all of the staff on this date due to staff not being present. Due to insufficient information available at this time, a follow up visit will be required at a later date.

Exit interview was conducted with Head Teacher, Millie Lim Wong. Appeal rights discussed and explained.


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: 10/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019
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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