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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670879
Report Date: 01/20/2023
Date Signed: 01/20/2023 03:38:31 PM


Document Has Been Signed on 01/20/2023 03:38 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:LBUSD-MUIR CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670879
ADMINISTRATOR:RANDY SANCHEZFACILITY TYPE:
850
ADDRESS:3105 EASY STREETTELEPHONE:
(562) 427-5515
CITY:LONG BEACHSTATE: CAZIP CODE:
90810
CAPACITY:72CENSUS: 0DATE:
01/20/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Cecilia Verduzco, Coordinating TeacherTIME COMPLETED:
03:45 PM
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On 01/20/2023 at 2:00 PM, Licensing Program Analyst (LPA) Katrina Chicote conducted an Unannounced - Case Management inspection to follow up on an incident that was reported to the Department on 01/18/2023. Upon arrival, LPA initially met with S2, who granted entry to facility. LPA announced purpose of inspection and met with Cecilia Verduzco, Coordinating Teacher. LPA did not observe any children at facility. Per CT, Part Day program, which is the only program facility currently operates, was already let out for the day. Part time program hours are from 9:30 AM to 12:30 PM Monday thru Friday.

On 01/18/2023, an incident was reported to The Department by Facility Representatives, where a parent alleges their child's personal rights were violated while in care. The purpose of the inspection was to obtain additional information regarding the allegation reported to The Department. There were no children available to interview and staff mentioned by parent was not present during inspection. During the inspection, LPA obtained documentation and interviews of available staff was conducted.

Incident was reported to The Department within 24 hours and report written received within seven days per Title 22 Regulation requirements.

Based on the information collected during this inspection, there is not enough information available at this time to substantiate the reported incident. Therefore, there were no deficiencies cited on this date.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Cecilia Verduzco.


Report Ends - Page 1 of 1
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2023
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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