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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570862
Report Date: 09/21/2022
Date Signed: 09/21/2022 03:36:46 PM


Document Has Been Signed on 09/21/2022 03:36 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 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: 111DATE:
09/21/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Cynthia AllenTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) T. Tran arrived at Ramona School to conduct an unannounced Case Management incident that was self-reported on 08/31/2022 regarding a child in care fell from playing with the swing. The Monterey Park South West Child Care Regional Office received the incident report on 09/06/2022. About 12:25 PM, LPA met with Cynthia Allen, Assistant Director and toured the facility. LPA observed proper care and supervision.

LPA completed files review for staff and child. Staff statement and child's record/doctor's note was obtained. Based on the information that were gathered through interviews with staff and other. On the day of the incident, there were four staff at the playground supervised 17 children. Parent was contacted immediately. Child was checked by the physician and no fractured on the right ankle. According to the available information, it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Cynthia Allen.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2022
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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