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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018121
Report Date: 02/16/2022
Date Signed: 02/16/2022 11:10:59 AM


Document Has Been Signed on 02/16/2022 11:10 AM - 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:ST. ANNE'S EARLY LEARNING CENTER AT HYANSFACILITY NUMBER:
198018121
ADMINISTRATOR:JENNY UNGERFACILITY TYPE:
850
ADDRESS:2737 HYANS ST.TELEPHONE:
(213) 381-2931
CITY:LOS ANGELESSTATE: CAZIP CODE:
90026
CAPACITY:26CENSUS: 16DATE:
02/16/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Melinda Body & Patty HernandezTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced Case Management inspection due to an incident which occurred on 01/11/22. LPA Mora met with Interim Center Manager Melinda Body and Center Manager Patty Hernandez. LPA was guided on a walk through of the facility at approximately 10:10 AM.

The alleged incident that occurred on 01/11/22 was reported to the Department on 01/18/22 via telephone. The facility reported the incident as soon as they became aware.

LPA conducted interviews with staff and obtained documentation during this visit.

It was alleged that a child was being forced to sleep on 01/11/22. Based on all information obtained on this date, and interviews conducted with staff, there were no disclosures made indicating that a child was being forced to sleep. There is no follow up is necessary regarding the incident.

The Notice of Site Visit (LIC 9213) – was provided and must remain posted for 30 days.

Exit interview was conducted. Appeal rights were explained and provided.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
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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