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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419009
Report Date: 10/10/2019
Date Signed: 10/10/2019 11:55:11 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:CII/HARVARD HEAD STARTFACILITY NUMBER:
197419009
ADMINISTRATOR:ANA PANIAGUAFACILITY TYPE:
850
ADDRESS:1506 W. 61ST STREETTELEPHONE:
(213) 385-5100
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:35CENSUS: 26DATE:
10/10/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Ana PaniaguaTIME COMPLETED:
12:15 PM
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On 10/10/19 at 8:15 AM, Licensing Program Analyst (LPA) Angelica Ramirez arrived at CII/Harvard Head Start for the purpose of following up on the unusual incident that occurred at the facility on 9/20/19. The El Segundo Regional Child Care Office received the report on 9/20/19. Upon arrival LPA met with Site Supervisor Ana Paniagua. LPA observed 13 children with two teachers in classroom #1 and 12 children with three teachers in classroom #2. All adults have a criminal record clearance.

According to the report, on 9/20/19 at approximately 08:23 AM during the sign in process, Individual #1 used inappropriate language in the classroom while speaking to Staff #1. According to the report, there were children present in the classroom.

During this inspection, LPA conducted interviews with facility staff, child, child's parent and Individual #1. LPA conducted a tour of the facility, obtained a copy of the roster, copy of Child #1's emergency information sheet and statements from staff members.

Based on statements obtained from interviews, there is not sufficient information to prove that Individual #1 used inappropriate language in the classroom. The facility followed Title 22 Regulations in reporting the incident to the Community Care Licensing Division.

Based on the information obtained throughout the course of the investigation, it does not appear that the facility violated Title 22 regulations. LPA provided consultation with the site supervisor regarding methods of communication with children's authorized representatives.

An exit interview was conducted and a copy of this report along with the Notice of Site Visit were provided to Ana Paniagua, Site Supervisor.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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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