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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018033
Report Date: 10/26/2022
Date Signed: 10/26/2022 04:14:46 PM

Document Has Been Signed on 10/26/2022 04:14 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:MAOF HEAD START - LINDSAYFACILITY NUMBER:
198018033
ADMINISTRATOR:YOLANDA VELAFACILITY TYPE:
850
ADDRESS:1584 E.MARTINLUTHERKING JR.BLVTELEPHONE:
3232332839
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 40TOTAL ENROLLED CHILDREN: 30CENSUS: 17DATE:
10/26/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Begly MunozTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA) T. Tran arrived at Lindsay Center Head Start to conduct a Case Management inspection that was self-reported on 09/22/2022 regards a care and supervision concern for a child in care. Upon arrival, LPA toured the home indoor and outdoor and observed proper care and supervision.

Staff and children files review was conducted. LPA obtained the child document and personnel report. LPA interviewed staff, child, and other. During the time the accident occurred, there were 15 children present with two teachers. Parent was notified in a timely manner. Based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.

No deficiency was cited 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 the facility representative Begly Munoz.

Trevino Cochran
Tiffanie Tran
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
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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