<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011629
Report Date: 11/05/2020
Date Signed: 11/05/2020 12:17:40 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:AZUSA DISCOVERY CENTERFACILITY NUMBER:
198011629
ADMINISTRATOR:LARA, BELENFACILITY TYPE:
840
ADDRESS:155 W. ARROW HIGHWAYTELEPHONE:
(626) 334-1806
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY:36CENSUS: 8DATE:
11/05/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Harishini Maddox, AdministratorTIME COMPLETED:
11:10 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
A Case Management inspection was conducted by Licensing Program Analyst (LPA) Fabiola Vasquez. LPA contacted the facility on 11/04/20 via telephone due to COVID-19 and precautionary measures. LPA spoke with Harshini Maddox, Administrator.

Census: 8 Staff: 1



The purpose of Case Management inspection was to clarify the center’s Disciplinary Protocol Policy in the Parent Handbook, and the Employee handbook section regarding planning of staff In-Service training when dealing with challenging behavior inside the classroom. The director will amend and submit the In-Service Training dates with topics covered including facilitators name conducting the trainings. A current Parent Handbook will also be submitted.

Exit interview was conducted with Harshini Maddox, Administrator via tele-inspection. This report along with a copy of the appeal rights will be sent to the Administrator via email with a read receipt which will act as the Administrator’s signature.

Due by;

Per administrator, was not continuing further.

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola VasquezTELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1