<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191597832
Report Date: 07/07/2022
Date Signed: 07/07/2022 03:56:18 PM


Document Has Been Signed on 07/07/2022 03:56 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:MAOF CHILD CARE CENTER - DOWNEYFACILITY NUMBER:
191597832
ADMINISTRATOR:ARACELY GARCIAFACILITY TYPE:
850
ADDRESS:8100 TELEGRAPH ROADTELEPHONE:
(562) 806-5054
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY:80CENSUS: 24DATE:
07/07/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Teacher Assistant, Miriam DiazTIME COMPLETED:
04:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On July 7, 2022 at 1:45 PM, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced inspection at the facility noted above and met with Teacher Assistant, Miriam Diaz. The purpose of the inspection was to conduct a case management inspection in regards to an incident that was reported by the facility to the Department on September 2, 2021. Upon arrival, 8 staff and 24 children were present.

The Department received an Unusual Incident/Injury Report (LIC 624) from the facility that reported that on September 1, 2021 during outdoor time about 9:15 AM, staff (S1) witnessed staff (S2) allegedly hitting child (C1) on the head while S1 was assisting the child with their shoe.

During the inspection, LPA conducted a walk through of the inside and outside of the facility accompanied by Teacher Assistant, Miriam Diaz. LPA observed surveillance cameras throughout the facility, including the outdoor play yard. LPA obtained a copy of the Personnel Report (LIC 500) that is dated April 2022. LPA conducted a telephone interview with staff (S3). LPA also conducted confidential interviews at the facility with S1 and S2.

LPA was informed that the agency conducted an internal investigation and found unsubstantial evidence to support the allegation. The evidence gathered during the internal investigation by the agency was surveillance footage and confidential interviews. LPA was informed that S2 was placed on suspension until the process of the investigation was concluded. LPA was also informed that staff received training after the incident on care and supervision.

LPA requested that the following documents be submitted via e-mail by July 14th: updated Personnel Report (LIC 500), official report for the internal investigation, suspension documentation, training documentation for S1 and S2, mandated reporter training certificates for S1 and S2, and an addendum report for the LIC 624.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique AyalaTELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MAOF CHILD CARE CENTER - DOWNEY
FACILITY NUMBER: 191597832
VISIT DATE: 07/07/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the information obtained during today's inspection, LPA determined that staff did not violate the child's personal rights therefore, no deficiencies were cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Teacher Assistant, Miriam Diaz.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique AyalaTELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2