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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015614
Report Date: 10/21/2021
Date Signed: 10/21/2021 10:02:39 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:COVINA EDUCATIONAL CENTER STATE PRESCHOOLFACILITY NUMBER:
198015614
ADMINISTRATOR:VANESSA BURGUENOFACILITY TYPE:
850
ADDRESS:160 N. BARRANCATELEPHONE:
(626) 974-4204
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY:72CENSUS: 33DATE:
10/21/2021
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Cristina Angelo, Site SupervisorTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Thelma Razo conducted a subsequent Case Management - Incident visit and greeted by teacher Martha Rivera. At 9:45AM, Site Supervisor Cristina Angelo arrived. LPA stated the purpose of the visit is due to Unusual Incident which occurred on 9/24/2021 involving two children.

On 10/1/2021, LPA toured the center to include the preschool playground, 3 classrooms and bathrooms. LPA interviewed 3 staff, and 4 children. Additional interviews were held by phone with 4 staff (10/4/2021 and 10/7/2021), and 5 parents on 10/4/2021. LPA attempted to interview Child #1 (C1) but was unsuccessful. LPA obtained police report.

Investigation has revealed that on 9/24/2021, C1's parent reported to the school an inappropriate behavior by another child which later was identified as Child #2 (C2). LPA interviewed Staff #1 and Staff #2 who were on duty the day of the alleged incident and both did not observe anything unusual that day. The other three staff interviewed who work with the children in the classroom have not disclosed any inappropriate contact between children in that class. LPA reviewed the police report dated 9/24/2021 and the case was closed due to no sign of abuse. Per C1's parent, C1 was seen by a physician and did not find any signs of abuse.

Based on interviews, observation, and information gathered, center was not cited under California Code of Regulations, Title 22, Division 12 at this time.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Martha Rivera

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
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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