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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004772
Report Date: 10/09/2024
Date Signed: 10/09/2024 03:04:23 PM


Document Has Been Signed on 10/09/2024 03:04 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:COUNTY KIDS' PLACEFACILITY NUMBER:
198004772
ADMINISTRATOR:MANLEY, KRISTINEFACILITY TYPE:
850
ADDRESS:2916 HOPE ST.TELEPHONE:
(213) 744-6241
CITY:LOS ANGELESSTATE: CAZIP CODE:
90007
CAPACITY:59CENSUS: 51DATE:
10/09/2024
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Maria LunaTIME COMPLETED:
03:35 PM
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Licensing Program Analysts (LPA) Claudia Kam and Joshua Ortega conducted a case management visit at the above facility for the purpose of follow up on an unusual incident reported on 8/14/24. Upon arrival, LPAs met with Maria Luna, assistant director who provided LPAs a tour of the facility. LPAs observed proper care and supervision.

LPAs completed child file review for medical care received. Child returned to care on 8/15/24. Play structure observed to be in good condition and age appropriate for children in care. Interviews were conducted with staff who observed incident and assistant director. On the day of the incident, there were 7 children with 2 teachers. Parent was notified of the incident immediately. Based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.


No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Maria Luna.

SUPERVISOR'S NAME: Denise GibbsTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Claudia KamTELEPHONE: (626) 602-6842
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2024
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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