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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417157
Report Date: 02/21/2020
Date Signed: 02/21/2020 10:17:39 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:CCRC HEAD START-COHASSET ELEMENTARY SCHOOLFACILITY NUMBER:
197417157
ADMINISTRATOR:SARINEH MATEVOSIANFACILITY TYPE:
850
ADDRESS:15810 SATICOY STREETTELEPHONE:
(818) 988-9169
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY:20CENSUS: 10DATE:
02/21/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Priscilla GomezTIME COMPLETED:
10:25 AM
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On 02/21/2020, Licensing Program Analysts (LPAs) Karren Starks and Laticia Thompson made an unannounced Case Management inspection due to an incident that occurred on 12/10/2019. LPAs observed 10 children in care at the time of inspection with proper Teacher/Child RatioS observed. Director Sarineh Matevosian arrived during inspection.

Based on the information obtained, On Tuesday 12/10/2019 during breakfast time, Child 1, tapped Staff 1, pointing to her genital area Child stated "Papa alla, Papa aqui" which means Dad here, Dad there, as she pointed to vagina. Child was doing movement with hand that was from the bottom to the top in the front of her vagina and said "grande Papa" which means Big Dad, while movements. Staff 1 asked child if needed to go to the bathroom and child said yes. As child was pulling pants down and underwear down, child said "aqui Papa" which means, here Dad, while pointing to vagina. Child also said "grande (pause) Papa" which means big (pause) Dad. Child then put finger in vagina, frowned and looked down. Child put index finger and thumb finger up in the air and said "chillo grande". Does not know what the first word means but knows that grande means big. DCFS and LAPD were notified on 12/10/2019. LAPD did report to interview child. Parent (mom) was present due to Center policy is to inform the parent when child discloses information. After interview child left with parent. Child reported to Center on 12/11/2019.

DCFS was contacted the day of the incident. LAPD was contacted arrived to the location and interviewed Child and Parent.

Based on this the facility followed protocols and contacted DCFS, Local Law enforcement and CCLD to report the incident within reporting time frames.

No deficiencies cited. Copy of report and Notice of Site visit issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020
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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