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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419346
Report Date: 01/18/2023
Date Signed: 01/18/2023 02:40:41 PM

Document Has Been Signed on 01/18/2023 02:40 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CHILDREN'S COLLECTIVE - HOPE MEMORIALFACILITY NUMBER:
197419346
ADMINISTRATOR:BACH, ROCIOFACILITY TYPE:
850
ADDRESS:3401 SOUTH SOMERSET DRIVETELEPHONE:
(310) 733-4388
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: DATE:
01/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:HR Manager Yolanda Walters and Program Manager Erynn Laurent TIME COMPLETED:
02:50 PM
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On January18, 2023 at 1:09 PM, an unannounced Case Management visit was conducted by Regional Manager (RM) Victor Bautista and Licensing Program Analyst (LPA) Antonio Almanza for the purpose of serving an Immediate Exclusion for Shavonne Gladney. RM and LPA met with HR Manager Yolanda Walters and Program Manager Erynn Laurent at the facility headquarters, located in Los Angeles Ca 90045.

Licensee representatives HR Manager Yolanda Walters and Program Manager Erynn Laurent were served with the following by Regional Manager Victor Bautista:

· ORDER TO INDIVIDUAL OF IMMEDIATE EXCLUSION FROM ALL FACILITIES: Shavonne Gladney


· Order to Licensee/Facility of Immediate Exclusion from Facility: Shavonne Gladney
· How to appeal
· Government Code 11522

RM and LPA advised Facility Representative that Shavonne Gladney is excluded from Children’s Collective – Hope Memorial and any other licensed facilities by the Department of Social Services. Licensee and Shavonne Gladney have 15 days to submit an appeal. The address for the appeal was provided to Licensee. Licensing staff served the exclusion letter to Shavonne Gladney via Certified mail on 01/18/2023.

Licensee representative Notified RM and LPA that Shavonne Gladney resigned 01/06/2023 and is not longer employed by the Licensee, Children's Collective.



Exit interview was conducted with HR Manager Yolanda Walters and Program Manager. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2023
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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