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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191800796
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:06:18 PM


Document Has Been Signed on 04/23/2024 03:06 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:GLENFELIZ BOULEVARD EARLY EDUCATION CENTERFACILITY NUMBER:
191800796
ADMINISTRATOR:GOAR GEGEYANFACILITY TYPE:
850
ADDRESS:3745 DOVER PL.TELEPHONE:
(323) 665-4165
CITY:LOS ANGELESSTATE: CAZIP CODE:
90039
CAPACITY:116CENSUS: 62DATE:
04/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Mrs. Mendoza TIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPAs) Roxana Lopez and Saul Valenzuela conducted an unannounced Case Management inspection due to 2 incidents that were reported to the Department on 2/14/2024 and 4/15/2024. A COVID 19 risk assessment was conducted. LPAs met with Teacher Veronica Avila and Office Manager Maria Mendoza.

On February 14th, 2024, an incident was self reported to the Department via Email by the facility who reported that a child's personal rights were possibly violated while in care.



On April 15th, 2024, an incident was self reported to the Department via Email by the facility who reported that an authorized representative informed them that child had disclosed that children's personal rights were violated while in care.

All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incidents reported to the Department.

During the inspection, LPA Lopez conducted interviews with staff and children. No disclosures were made by children or staff.

LPA's provided a copy of regulation 101212 reporting requirements- and discussed incidents that should be reported.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative, Maria Mendoza.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024
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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