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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001351
Report Date: 06/28/2022
Date Signed: 06/28/2022 11:21:08 AM


Document Has Been Signed on 06/28/2022 11:21 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 CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:92ND & MAIE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198001351
ADMINISTRATOR:ALICIA GARCIAFACILITY TYPE:
850
ADDRESS:9200 MAIE AVE.TELEPHONE:
(323) 249-0621
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY:54CENSUS: 19DATE:
06/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Anadia Leal, Teacher TIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Katrina Chicote conducted an unannounced case management inspection to follow up on an incident that was reported to the Department on 06/24/2022. Upon arrival, LPA met with Anadia Leal, who provided LPA a tour of the facility inside and outside. Census was taken.

On 06/24/2022, an incident was self-reported to the Department where a parent made an allegation that their child's personal rights were violated while in care to the Director. The facility reported this incident to the Department within the required 24 hours. During this inspection, LPA interviewed children and staff at facility. Staff members were aware of alleged incident, A2 & A3 were notified of incident while A4 disclosed to LPA that he was present when alleged incident took place. LPA interviewed three children at facility who consistently stated that they enjoy coming to school and felt safe with their teachers.

Director stated that facility is conducting their own investigation on the incident and will be providing trainings to staff in regards to Personal Rights and Managing Challenging Behaviors with Children. LPA obtained documentation available at time of inspection.

Based on the information obtained and LPA observation, LPA determined there will be no deficiencies cited at this time, per California Code of Regulations Title 22, Division 12.

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 conducted and report reviewed with, Anadia Leal.

Report Ends - Page 1 of 1
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022
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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