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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000638
Report Date: 08/18/2021
Date Signed: 08/18/2021 12:02:39 PM

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:YOUNG HORIZONS CHILD DEVELOPMENT CENTERSFACILITY NUMBER:
198000638
ADMINISTRATOR:ARIANA CHAVEZFACILITY TYPE:
850
ADDRESS:501 ATLANTIC AVETELEPHONE:
(562) 437-8991
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:65CENSUS: 43DATE:
08/18/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:16 AM
MET WITH:Ariana ChavezTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management Incident inspection. This inspection is regarding incident that took place on June 11, 2021. Licensing Program Analyst met with Site Supervisor Ariana Chavez who providing information and assistance for the inspection.

During the course of the inspections, LPA conducted interviews with first hand witnesses (children and staff) regarding the incident. LPA also reviewed internal incident reports provided by the facility. There was no corroborated disclosure which indicates a Title 22 violation occurred regarding the alleged incident. Based on interviews and review of internal reports there were no violations of Title 22 requirements.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Site Supervisor Ariana Chavez.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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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