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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191800600
Report Date: 09/20/2021
Date Signed: 09/20/2021 12:57:21 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HILLTOP NURSERY SCHOOL, INCFACILITY NUMBER:
191800600
ADMINISTRATOR:PEARL THIENKOSOLFACILITY TYPE:
850
ADDRESS:3625 MARATHONTELEPHONE:
(323) 663-3025
CITY:LOS ANGELESSTATE: CAZIP CODE:
90026
CAPACITY:44CENSUS: 23DATE:
09/20/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Camille Montiel TIME COMPLETED:
11:55 AM
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Licensing Program Analyst (LPA) conducted a case management inspection due to an incident that occurred on 10/20/20. LPA met with Teacher Camille Montiel. Interim Director, Isabel Trejo, was not available at the time of arrival but arrived during the inspection. LPA conducted interviews and obtained documentation during this visit.

At the time of arrival, LPA observed 10 children with 02 staff in the front yard and 13 children with 03 staff in the back yard. Staff to children ratios were observed to be in accordance with Title 22 regulations.

The incident which occurred on 10/20/20 was reported to the Department on 10/20/20 via telephone. The facility did report the incident in a timely manner.

On 10/20/20 a child began to choke on a piece of asphalt. Staff were able to help the child and get the piece out before the paramedics arrived. Based on all information obtained on this date and interviews conducted with teachers, no follow-up is necessary regarding the incident. The incident appears to be an unusual accident. There is nothing the facility staff could have done to prevent the incident from occurring. Staff did place a cone in the area where there is loose gravel to keep the children away from the area. Staff are also ensuring that children do not have anything in their hands and pockets when it is nap time.

The Notice of Site Visit (LIC 9213)must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued. Exit interview was conducted with Isabel Trejo. Appeal rights explained & provided.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2021
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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