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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011088
Report Date: 03/11/2020
Date Signed: 03/11/2020 12:06:47 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:PACE HEAD START/EVEN START CENTERFACILITY NUMBER:
198011088
ADMINISTRATOR:MARTHA HERNANDEZFACILITY TYPE:
850
ADDRESS:2300 W. JAMES M. WOOD BLVD.TELEPHONE:
(213) 738-7295
CITY:LOS ANGELESSTATE: CAZIP CODE:
90006
CAPACITY:30CENSUS: 35DATE:
03/11/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Site SupervisorTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) T. Tran arrived at PACE Head Start/Even Start Center to gather information on a Case Management Incident that was self-reported on 03/02/2020. The 24 hours self-report was made on 03/04/2020. The Monterey Park South West Child Care Regional Office received the written incident report on 03/06/2020.

Upon arrival, LPA met with site supervisor, about 10:10 a.m. we toured the facility. During the inspection, LPA observed proper care and supervision. No child's record was reviewed. LPA obtained personnel report, children's roster, and other documents. LPA conducted an interview with center staff for the record.

An exit interview was conducted. The content of this report was read and discussed with the noted person. Notice of site visit was provided and 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: 03/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020
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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