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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492952
Report Date: 03/30/2022
Date Signed: 03/30/2022 11:39:06 AM


Document Has Been Signed on 03/30/2022 11:39 AM - It Cannot Be Edited

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:COALICION DE LATINOS AMERICANOS, INC.FACILITY NUMBER:
197492952
ADMINISTRATOR:RUIZ, FABIOLAFACILITY TYPE:
850
ADDRESS:3130 W. 139TH STREETTELEPHONE:
(562) 279-6330
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:40CENSUS: 16DATE:
03/30/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cynthia Navarro, Site DirectorTIME COMPLETED:
12:00 PM
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On 03/30/22 Licensing Program Analyst (LPA), Lisa Clayton arrived at the facility unannounced to conduct a Case Management inspection to follow up on an Unusual Incident reported to the department on 01/07/2022. LPA Clayton met with Site Director Cynthia Navarro. Also present were 2 teachers and 5 children in care.

Description of incident : Per the UIR, due to the rising COVID-19 cases in Los Angeles County and teacher shortage, Carlos Ruvalcaba, Executive Director, decided to close the school for one week, due to reopen on Tuesday, January 18. 2022.

Per the Director and Program Director Crystal Parbol, the facility was closed from 01/10/2022 - 02/01/2022.

LPA reminded Director Cynthia to continue to report and submit Unusual Incident Reports in a timely manner.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2022
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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