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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671133
Report Date: 10/10/2024
Date Signed: 10/10/2024 10:44:10 AM

Document Has Been Signed on 10/10/2024 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-TWAIN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191671133
ADMINISTRATOR/
DIRECTOR:		KELLIE HAUSERFACILITY TYPE:
850
ADDRESS:4666 SUNFIELD AVE.TELEPHONE:
(562) 425-2735
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 39DATE:
10/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Program Coordinator TIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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Licensing Program Analysts(LPAs) Jeanette Estrada and Portia Bowden conducted a case management inspection at the facility. LPAs met with Program Coordinator Mary Lopez and explained the reason for the visit. All children were observed in the outdoor area upon LPAs' arrival. LPAs observed 6 staff supervising 39 children.

Program Coordinator Cristabel Rodriguez arrived at a later time.

The facility submitted an Unusual Incident Report to the Department on 10/8/24. During today's visit, LPAs collected copies of LIC 9040 and LIC 500, reviewed staff files and collected other pertinent documents.

LPAs will return for further investigation.

Exit interview conducted with Facility Representatives. A copy of this report and a Notice of Site Visit were provided. Facility Representatives were advised Notice of Site Visit must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
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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