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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500256
Report Date: 01/16/2025
Date Signed: 01/16/2025 09:18:00 AM

Document Has Been Signed on 01/16/2025 09:18 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:WILLIAMS HEAD STARTFACILITY NUMBER:
191500256
ADMINISTRATOR/
DIRECTOR:		ROSA GUERRAFACILITY TYPE:
850
ADDRESS:2444 N. DEL MAR AVE.TELEPHONE:
(626) 307-3400
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY: 188TOTAL ENROLLED CHILDREN: 17CENSUS: 15DATE:
01/16/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Patricia Yaghnam, Early Care Manager TIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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On 01/16/2025, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted. LPA met with Patricia Yaghnam, Early Care Manager and explained the purpose of the visit. There are 17 children enrolled and 15 are present with 2 Staff in Classroom #9.

The purpose of the visit is to follow up on an incident that occurred on 11/21/2024 and was reported to the department on 11/22/24. The self reported incident is regarding supervision and physical environment.

During today's inspection, LPA interviewed Staff #2 (S2) and attempted to interview Child #1 (C1).

Based on interviews with S1, S2 and observations, there were no corroborating information to determine that a supervision or a physical environment violation occurred. The facility is not being cited any deficiencies today.

An exit interview was conducted and a copy of this report was provided to the Early Care Manager.

A Notice of Site Visit was provided; Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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