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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413346
Report Date: 04/05/2021
Date Signed: 04/08/2021 09:33:04 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:JUNIORVERSITYFACILITY NUMBER:
197413346
ADMINISTRATOR:CREWS, GWENDOLYNFACILITY TYPE:
850
ADDRESS:2400 CENTRAL AVENUETELEPHONE:
(310) 638-3500
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY:83CENSUS: 13DATE:
04/05/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Gwendolyn Crews-DirectorTIME COMPLETED:
10:30 AM
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This is an unannounced Case Management Inspection call conducted on 04/05/21 at 9:30 AM by Alicia Bailey Licensing Program Analyst (LPA). Due to COVID-19 and precautionary measures this case management inspection call was conducted via telephone with director Gwendolyn Crews regarding the usual incident report received in the office on 02/8/2021 regarding child behavior.

On 2/8/21 director Crews submitted an unusual incident report to the Department for the incident on 02/5/21. LPA Bailey interviewed Director Crews via phone on 04/05/21 regarding C1 behavior during that incident. The Interview with the director and information disclosed the parents and director came to mutual agreement to withdraw C1 out of the school program due to challenging behavior and the school unable to meet the child's needs during this time. C1 is no longer attending the facility as of 02/10/2021.

Based on all information obtained on this date, and interview conducted, no follow-up is necessary regarding the incident as immediate action was taken by the parents and the facility. LPA determined there were no violations that resulted in the incident nor resulted from the incident. No deficiencies were cited on this date. Director met reporting requirements for this incident.

Exit interview was conducted with Director Gwendolyn Crews. This report along with a copy of the appeal rights will be sent to the director via email with a read receipt or confirmation of receipt of email, which will act as the Applicants/Licensee’s signature. A copy of the signed report will also be sent to the Department.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021
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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