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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890344
Report Date: 02/25/2025
Date Signed: 02/25/2025 02:41:31 PM

Document Has Been Signed on 02/25/2025 02:41 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:EVERGREEN EARLY EDUCATION CENTERFACILITY NUMBER:
191890344
ADMINISTRATOR/
DIRECTOR:		XOCHITL SANCHEZFACILITY TYPE:
850
ADDRESS:1027 N EVERGREEN AVETELEPHONE:
(323) 269-0406
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 162TOTAL ENROLLED CHILDREN: 80CENSUS: 58DATE:
02/25/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Xochitl Sanchez, PrincipalTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to an incident that was reported to the Department on 12/12/2024. LPA met with Principal Xochitl Sanchez who guided LPA on a tour of the facility. Census was taken.

On December 12th, 2024, an incident was self-reported to the Department via Email by the facility who reported that a child managed to open the outdoor play ground side door.



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 Valenzuela conducted interview with Principal. Per Principal that during outdoor play time they observed Child #1 walking on the side of the play ground. According to the Principal they continued to observe Child #1 as they proceeded to walk towards the door. Principal stated that the child managed to open the door and child took one step out, and the Principal was able to prevent the child from walking out of the premises. Per Principal, they added chain hooks to prevent children from opening the door during outdoor play time.

LPA 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, Xochitl Sanchez.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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