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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570862
Report Date: 11/02/2023
Date Signed: 11/02/2023 03:39:33 PM


Document Has Been Signed on 11/02/2023 03:39 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
MONTEREY PARK SW RO, 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:357CENSUS: 167DATE:
11/02/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Assistant Director, Amie Wilson-BirdTIME COMPLETED:
04:00 PM
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On November 2,2023 at 1:00 pm, Licensing Program Analysts (LPAs) A. Wallin and T. Tran conducted a Case Mangagement Incident Inspection. This inspection is regarding a personal rights incident that took place on October 24, 2023 in which a child was hit by a toy thrown from another child. LPAs met with assistant director, Amie Wilson-Bird who provided information and assistance during the inspection. A census of 167 was taken.

During the inspection LPAs conducted interviews 3 staff and 2 children interviews. LPAs also reviewed the the following documents: a October 24, 2023 unusual incident report, collected LIC 500 personnel sheet, review staff and children's file, collected attendance on the day of the incident, and collected child's record information. During conducted interviews, no concern regarding lack of supervision was observed. No Title 22 violations observed regarding incident.

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, Amie Wilson-Bird.

SUPERVISOR'S NAME: Denise GibbsTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2023
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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