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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001022
Report Date: 05/17/2024
Date Signed: 05/17/2024 10:03:03 AM


Document Has Been Signed on 05/17/2024 10:03 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MAOF CHILD CARE CENTER-FORDFACILITY NUMBER:
198001022
ADMINISTRATOR:NORMA FIGUEROAFACILITY TYPE:
850
ADDRESS:330 SOUTH FORD BLVD.TELEPHONE:
(323) 264-4333
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY:72CENSUS: 34DATE:
05/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Nora Lopez, Site DirectorTIME COMPLETED:
10:20 AM
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On May 17, 2024, Licensing Program Analysts (LPAs), Monique Ayala and Priscilla Ochoa conducted an unannounced case management inspection. The purpose of the inspection is to follow up on an incident report that reported on 03/27/2024 and was reported to the department in a timely manner. The incident is a possible personal rights violation. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with Site Director, Nora Lopez who guided LPA on a tour of the facility. LPA observed 34 children in care.

During the investigation LPAs a current facility roster, LPA interview Staff #1 (S1) and Staff #3 (S3) and attempted to contact Staff #2 (S2). LPA attempted to interview Child #1 (C1). LPAs interviewed Parent #1 (P1) and Parent #2 (P2).

Based on interviews conducted there was no corroborating information to verify that possible personal rights were violated. There will be no deficiencies cited today, 05/17/2024.

An exit interview was conducted and a copy of this report was provided to the Site Supervisor, along with Notice of Site Visit. Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2024
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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