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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671133
Report Date: 04/06/2023
Date Signed: 04/06/2023 01:16:01 PM

Document Has Been Signed on 04/06/2023 01:16 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-TWAIN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191671133
ADMINISTRATOR:KELLIE HAUSERFACILITY TYPE:
850
ADDRESS:4666 SUNFIELD AVE.TELEPHONE:
(562) 425-2735
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 34DATE:
04/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Kellie Hauser, Coordinating Teacher (CT)TIME COMPLETED:
01:45 PM
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On 04/06/2023 at 12:40 PM Licensing Program Analysts (LPAs) Katrina Chicote and Franchesca White conducted an unannounced case management inspection to follow up on an incident that was reported to the Department on 02/16/2023. Upon arrival, LPAs met with Kellie Hauser, Coordinating Teacher (CT), who provided LPAs on a tour of the facility inside and outside. Census was taken. LPAs arrived during nap time and observed preschoolers napping on cots.

On 02/16/2023, an incident was reported to The Department regarding construction occurring at the facility replacing the playground matting under the play structure. Per report, construction was set to finish on 03/31/2023. LPAs interviewed CT which stated that construction has concluded. LPAs observed two play structures in outdoor play yard with the cushioning material below to absorb fall to be free of hazards and well maintained. Per CT, outdoor play yard was still used by children as construction occurred on one play structure at a time and the area that was worked on would be fenced off making it off limits to children while outside.

The facility reported this incident to the Department within the required 24 hours and submitted a written report within seven days.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit 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), Kellie Hauser.

Report Ends - Page 1 of 1
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2023
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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