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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570862
Report Date: 09/29/2021
Date Signed: 09/29/2021 02:06:06 PM

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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:RAMONA SCHOOLFACILITY NUMBER:
191570862
ADMINISTRATOR:LAUREL PARKERFACILITY TYPE:
850
ADDRESS:14616 DINARDTELEPHONE:
(562) 210-4205
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:375CENSUS: 139DATE:
09/29/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Loretta Gallegos, Assistant DirectorTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA), T. Tran arrived at the above licensed facility to conduct a Case Management Incident inspection that was self-reported on 9/02/2021. The Monterey Park South West Child Care Regional Office received the incident report on 09/02/2021. During the inspection, LPA observed proper care and supervision.

Files review were conducted, and child's document obtained. Interviews were conducted, per staff during outside time, staff observed C1 was going up the play structure and missed steps. Child fell face down and sustained cut near the glabella area. Parent was contacted. Child received medical care and no restriction upon return to school. Based on the available information, staff provided proper care and supervision during the time of the incident. At this time based on the available information it does not appear this incident was the result of a Title 22 violation.

The content of this report was read and discussed in detail the noted person.

An exit interview was conducted; the notice of site visit must be posted for 30 days upon receipt.


SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021
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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