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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006099
Report Date: 01/07/2020
Date Signed: 01/07/2020 12:45:17 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:RANCHO LOS AMIGOS CHILDREN'S CENTERFACILITY NUMBER:
198006099
ADMINISTRATOR:HELIA CASTELLONFACILITY TYPE:
830
ADDRESS:7755 GOLONDRINAS STREETTELEPHONE:
(562) 401-7981
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:35CENSUS: 28DATE:
01/07/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Center DirectorTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA), Tiffanie Tran arrived at the above facility to conduct a Case Management Incident inspection that was self-reported on 09/06/2019. The 24 hours self-report was made in a timely manner. The Monterey Park South West Child Care Regional Office received the incident report on 09/06/2019. During the inspection, LPA observed proper care and supervision.

LPA completed staff and children review. LPA obtained personnel report, child record and daily signed in. Based on the available information and interviews were conducted. Staff indicated, on the day of the incident there were 12 infants with three staff were present. During feeding time, center staff observed C1 was walking near the feeding area to be close to the staff and peers he slipped on his sock and hit his right eye of on the edge of the wooden feeding table. C1 sustained a small laceration near the right eye. Medical attention required. Parent was contacted in a timely manner. To prevent future incidents from reoccurrence, staff had replaced the wooden feeding table with individual tables for the safety of the children in care. And parents were reminded to provide walking children with shoe for safety purposes. Center staff provided proper care and supervision during the time of the incident. At this time based on the available information it does not appear this incident was the result of a Title 22 violation. However, based on record reviewed, S2 was does not have infant unit to qualified her as an infant teacher. Deficiency had been cited under the annual inspection on 01/07/2020.

The content of this report was read and discussed in detail at the time of with the noted contact person.

An exit interview was conducted; the notice of site visit must be posted for 30 days upon receipt.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020
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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