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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570789
Report Date: 02/02/2023
Date Signed: 02/02/2023 03:08:59 PM


Document Has Been Signed on 02/02/2023 03:08 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MOUNTAIN VIEW CHILDREN CENTERFACILITY NUMBER:
191570789
ADMINISTRATOR:ALMA GONZALESFACILITY TYPE:
850
ADDRESS:2109 BURKETT RDTELEPHONE:
(626) 652-4250
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY:69CENSUS: 36DATE:
02/02/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Samara Baker & Claudia Casillas Program Facilitators TIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced Case Management inspection. Due to COVID- 19 precautionary measures were taken, appropriate PPE was used. LPA met with Samara Baker and Claudia Casillas, program facilitators who guided LPA on a tour of the facility. Census was taken.

The purpose of this inspection is due to an incident that was reported to the Department on September 21, 2022. The facility reported this incident to the Department within the required 24 hours.



Based on information obtained during this inspection, no follow up is necessary regarding the incident reported. The facility followed all proper procedures.

At this time, the facility is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Program Manager Jennifer Camargo --------------------- pg. 1 of 1 -----------------------

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2023
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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