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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011010
Report Date: 10/04/2022
Date Signed: 10/04/2022 04:01:13 PM


Document Has Been Signed on 10/04/2022 04:01 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:YOUNG HORIZONS-GRISHAM SITEFACILITY NUMBER:
198011010
ADMINISTRATOR:NICETA TANDOCFACILITY TYPE:
850
ADDRESS:11 W. 49TH STREETTELEPHONE:
(562) 984-3801
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:24CENSUS: 16DATE:
10/04/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Assistant Supervisor - Esmeralda DuenasTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced case management visit on 10/04/22. The purpose of this visit is to follow up on an Unusual Incident that was reported on 09/13/22. LPA met with assistant supervisor, Esmerlada Duenas, who guided LPA on a tour of the facility. LPA observed 4 teachers and 16 children in care. During the visit, LPA observed the overall cleanliness of each classroom. LPA also observed each bathroom designated for children in care to be sanitary and free of any defects. Food prep area was also observed to be clean and sanitary. Spray bottles labeled "bleach solution" were observed in each classroom. LPA also observed containers labeled "bleach solution" to have dirty toys. Per supervisor, dirty toys are sanitized after use before being used again. LPA conducted follow up interview with Assistant Supervisor during visit.

Based on observations and interviews, this incident did not result in a violation of California Code of Regulation Title 22. No deficiencies will be cited today.

An exit interview was conducted, appeal rights provided, and report was reviewed with Assistant Supervisor, Esmeralda Duenas.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2022
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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