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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191605684
Report Date: 01/17/2020
Date Signed: 01/17/2020 01:42:22 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:CALIFORNIA HEIGHTS UNITED METHODIST CHILDREN'S CTRFACILITY NUMBER:
191605684
ADMINISTRATOR:MARIA VARGASFACILITY TYPE:
840
ADDRESS:3759 ORANGE AVENUETELEPHONE:
(562) 595-0056
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY:120CENSUS: 28DATE:
01/17/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:April Behrendt, DirectorTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), Dayna Chambers, conducted a Case Management Incident inspection to follow up on a self-reported incident that occurred at at 5:12pm on 09/23/2019. The Monterey Park South West Child Care Office received the incident report on 09/24/2019 by licensee, April Behrendt, Director. Report stated that on 09/23/2019, Child #1, 10 years old, started running to play on the playground and fell and hit right wrist. Child complained about the pain to teacher. There were two teachers supervising and witnessed the incident. LPA met with licensee and confirmed facility was properly cared for during the incident. On 01/17/2020 at 12:30pm, LPA and licensee toured the facility, at the time of the inspection all ratios were compliant according to Title 22 Regulations.

Based on today’s inspection, and interviews conducted, the facility followed the appropriate Reporting Requirements, Notified Parents, and cared for child properly. LPA obtained documents confirming parents were notified. The Director contacted the dad at the time of the incident.

At this, based on the available information, it does not appear this incident was the result of a Title 22 violation and the facility followed the appropriate regulations to care for the children in care.

The content of this report was read and discussed in detail at the time of with licensee April Behrendt, Director.

Upon receipt, Notice of Site Visit shall be posted. Notice of Site Visit shall be posted for thirty (30) days. Failure to maintain posting as required will result in a $100 civil penalty.

An exit interview was conducted, and a copy of this report was provided to April Behrendt, Director. Notice of Site visit was issued.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna ChambersTELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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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