<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411387
Report Date: 06/21/2019
Date Signed: 06/21/2019 10:32:11 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:CLEVELAND EARLY EDUCATION CENTERFACILITY NUMBER:
197411387
ADMINISTRATOR:VASQUEZ, SARAFACILITY TYPE:
850
ADDRESS:19031 W. STRATHERN STREETTELEPHONE:
(818) 718-9420
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:120CENSUS: 79DATE:
06/21/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Allison Chung - Head Teacher TIME COMPLETED:
10:50 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Peter Flores, conducted a Case Management Incident inspection to follow up on the self reported incident that occurred at Cleveland Early Education Center on January 31, 2019. The El Segundo Child Care Office received the incident report via e-mail on February 5, 2019.

LPA met with Head Teacher Alison Choi, who guided analyst on a tour of the facility. LPA observed 79 children present and 21 staff members. LPA verified that all adults present in the facility have obtained criminal record clearances and are associated to the facility.

On the unusual incident, reporter stated that a staff member displayed aggressive behavior in the classroom.

Staff states that the incident happened so fast and the children were distracted with classroom activities and did not notice the incident.

Staff took proper precaution and informed the Director. Staff is no longer employed at the Facility. At this time, based on the available information, it does not appear this incident was the result of a Title 22 violation.

The notice of site visit must be posted for 30 days upon receipt.

An exit interview was conducted and a copy of this report was given to Alison Choi, Head Teacher.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1