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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013102
Report Date: 02/21/2020
Date Signed: 02/21/2020 09:25:50 AM

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:NEW LIBERTY CHILD DEVELOPMENT CENTER/DREWFACILITY NUMBER:
198013102
ADMINISTRATOR:DIANN FAUNTLEROYFACILITY TYPE:
850
ADDRESS:5328 CENTRAL AVENUETELEPHONE:
(323) 234-3167
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:82CENSUS: 39DATE:
02/21/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:37 AM
MET WITH:Alchai JonesTIME COMPLETED:
09:35 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
Licensing Program Analysts (LPAs) Mayra Rivera and Ariel Cazares conducted a Case Management inspection at facility to follow up on the self reported incident that occurred on 01/15/2020. LPA’s met with Early Head Start Manager Alchai Jones who guided the LPA’s on a tour of the facility.

LPA Rivera during investigation interviewed parent, staff, reviewed records, and obtained copies of relevant documents. Based on inspection, interviews and documents received, it was determined that there were 3 staff members strategically placed supervising children at the time of the incident. Staff #1 stated that before they could react, child #1 hit child #2 with a toy. The children were being actively supervised, therefore LPA Rivera determine there to be no violation of Tittle 22.

Upon receipt, Notice of Site Visit shall be posted for thirty (30) consecutive days where the parent/guardian of children enter and exit the facility Failure to maintain posting as required will result in a $100 civil penalty.

Exit interview conducted with Director of Education Diann Fauntleroy during which appeal rights were explained. A copy of the appeal rights (LIC9058 01/16) were provided. The Licensee’s signature on this report acknowledges receipt of her rights.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020
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