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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402062
Report Date: 06/12/2023
Date Signed: 06/12/2023 12:32:11 PM


Document Has Been Signed on 06/12/2023 12:32 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:WILTON PLACE EARLY EDUCATION CENTERFACILITY NUMBER:
197402062
ADMINISTRATOR:RICKY LIMFACILITY TYPE:
850
ADDRESS:4030 LEEWARD AVENUETELEPHONE:
(213) 383-4971
CITY:LOS ANGELESSTATE: CAZIP CODE:
90005
CAPACITY:110CENSUS: 56DATE:
06/12/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Marina Torres-Montano, Head TeacherTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Mireya García conducted an unannounced Case Management inspection due to an incident that was reported to the Department on April 14, 2023. LPA met with Head Teacher Marina Torres-Montano who guided LPA on a tour of the facility. Principal Ricky Lim was not present during this inspection. Census was taken.

On April 14, 2023, an incident was self reported to the Department via telephone by the facility who reported a parent contacted staff to notify that child #1 had "nail print" marks by the rib cage area.

The purpose of the inspection was to obtain additional information regarding the incident reported to the Department. During the inspection, LPA obtained a copy of the LIC 9040 Children's roster dated 06/12/23, Declaration from Staff #2- signed written statements dated 06/12/23, picture of child #1's right rib cage (where two scars where visible) and conducted interviews with Staff #2, child #1 and telephone interview with parent #1.

LPA was unable to complete interviews on this date. Due to staff not being present at this time, a follow up visit will be required at a later date.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Marina Torres-Montano.

END OF REPORT: PAGE 1 OF 1.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023
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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