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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870902
Report Date: 12/17/2019
Date Signed: 12/17/2019 10:38:04 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WANDA A. MIKES EARLY EDUCATION CENTERFACILITY NUMBER:
191870902
ADMINISTRATOR:REED, ALICEFACILITY TYPE:
850
ADDRESS:7720 SOUTH VERMONT AVENUETELEPHONE:
(323) 758-1136
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:116CENSUS: 63DATE:
12/17/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:Greg Johnson, PrincipalTIME COMPLETED:
11:00 AM
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Community Care Licensing received an Unusual Incident Report on 10/01/2019 in relation to Child #1’s inappropriate behavior, which may be a Personal Rights issue violation. Inquiry was taken by Jose Santana on 10/21/19 from the Department of Investigation Branch. Investigator Santana conducted interview with C1 and forwarded the investigation interview to the El Segundo Regional Office.

On 12/17/19 @ 9:11 am, Licensing Program Analyst ( LPA’s) Lourdes Castellanos and Ericka Hill initiated follow-up interviews with Staff #1 (Principal), Staff #2, Staff #3, Staff #4 and Staff #5 in classroom 3. Based on the interviews and inquiries, Personal Rights was not violated, and the facility followed protocol requirements. Staff #1, Principal, was notified by Staff #2 about the incident. Child #1 recanted the allegation indicating that he was lying while he was questioned on more than one occasion.

Based on the available information it does not appear this incident was the result of a Title 22 violation for personal rights. No deficiencies were observed during the visit.

An exit interview was conducted and a copy of this report, appeal rights and a Notice of Site Visit were provided to Greg Johnson, Principal.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Lourdes CastellanosTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019
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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