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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670974
Report Date: 12/16/2022
Date Signed: 12/16/2022 10:44:10 AM

Document Has Been Signed on 12/16/2022 10:44 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-MANN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670974
ADMINISTRATOR:ROBBIE WADELLFACILITY TYPE:
850
ADDRESS:3215 E VISTA AVETELEPHONE:
(562) 439-7896
CITY:LONG BEACHSTATE: CAZIP CODE:
90803
CAPACITY: 48TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
12/16/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Vivian Vasquez, TeacherTIME COMPLETED:
11:10 AM
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On 12/16/2022 at 9:20 AM Licensing Program Analyst (LPA) Katrina Chicote conducted an unannounced case management inspection to follow up on an incident that was reported to the Department on 12/08/2022 via telephone. Upon arrival, LPA announced purpose of inspection and initially met with Teacher, Vivian Vasquez, who granted entry to the facility. Nancy Perez, Coordinating Teacher, who reported incident arrived at facility at 10:15 AM to continue inspection.

Incident was reported within 24 hours and a written report was received within seven days, meeting Title 22 regulations reporting requirements.

On 12/08/2022, an incident was reported to The Department where a parent reported to facility staff that alleges that child's personal rights were violated while in care. The purpose of the inspection was to obtain additional information regarding the allegation reported to The Department. During the inspection LPA interviewed staff who received information from parent and children involved in alleged incident. LPA toured bathroom where alleged incident took place and reviewed supervision policies with staff and obtained pertinent documents during inspection.

Based on the information collected during this inspection, there is not enough preponderance of evidence to substantiate the reported allegation. Therefore, there were no deficiencies cited on this date.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Nancy Perez.
Report Ends - Page 1 of 1
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2022
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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