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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004772
Report Date: 09/01/2022
Date Signed: 09/01/2022 04:45:05 PM


Document Has Been Signed on 09/01/2022 04:45 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:COUNTY KIDS' PLACEFACILITY NUMBER:
198004772
ADMINISTRATOR:MARTINEZ, EDITHFACILITY TYPE:
850
ADDRESS:2916 HOPE ST.TELEPHONE:
(213) 744-6241
CITY:LOS ANGELESSTATE: CAZIP CODE:
90007
CAPACITY:59CENSUS: 12DATE:
09/01/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:48 PM
MET WITH:Edith Martinez, DirectorTIME COMPLETED:
04:57 PM
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On Thursday, September 1, 2022 at 2:48 p.m., Licensing Program Analysts (LPAs) Mayra Rivera and Patricia Medel conducted a Case Management inspection at facility to follow up on the self reported incident that occurred on 06/6/22. LPA’s met with Site Supervisor Maria Luna who guided the LPA’s on a tour of the facility. During the toured, LPA Rivera observed 12 children napping with Staff #1.

LPA Rivera during investigation interviewed staff, reviewed records, and obtained copies of relevant documents. Based on inspection, interviews and documents received, it was determined that there were 2 staff members were placed outside supervising children at the time of the incident and the facility followed procedures in providing first aid. Staff #1 stated she observed the incident. The children were being actively supervised, therefore LPA Rivera determine there to be no violation of Tittle 22.

Upon receipt, Notice of Site Visit shall be posted for thirty (30) consecutive days where the parent/guardian of children enter and exit the facility Failure to maintain posting as required will result in a $100 civil penalty.

Exit interview conducted with Director Edith Martinez during which appeal rights were explained and provided.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022
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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