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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191805630
Report Date: 10/03/2024
Date Signed: 10/03/2024 03:31:31 PM

Document Has Been Signed on 10/03/2024 03:31 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:JOSEPH A. GASCON ELEMENTARY HEAD STARTFACILITY NUMBER:
191805630
ADMINISTRATOR/
DIRECTOR:		MARIANA SANCHEZFACILITY TYPE:
850
ADDRESS:630 S. LEONARD AVE.TELEPHONE:
(323) 721-2025
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: DATE:
10/03/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Education Specialist, Vanessa GuzmanTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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On On October 3, 2024, Licensing Program Analysts (LPAs) Priscilla Ochoa and Monique Ayala conducted an unannounced case management- annual continuation inspection at the Montebello Unified School District Head Start Headquarters at 8432 Birchbark Ave. Pico Rivera, CA 90660. The purpose of this inspection is to review staff files for the above facility. LPAs were greeted by Education Specialist, Vanessa Guzman and Program Specialist, Vicky Bermudez who provided LPAs with staff files.
During this inspection, LPAs reviewed files for Staff #1 – Staff #4 which are missing LIC 503 and Staff #3 – Staff # 4 are missing immunization records. Per Program Specialist, these documents are housed at the Human Resource Office at the Montebello Unified School District, 123 S. Montebello Blvd. Montebello, CA 90640. LPAs will complete file review at a later day, as office closes at 3:30 pm.

This facility is not being cited any deficiencies today, October 3, 2024. LPA provided a copy of Title 22 Regulation: Personnel Records, 101217. LPAs informed Education Specialist and Program Specialist to submit an agreement/waiver request to have all completed staff files at one district office.



An exit interview was conducted, and a copy of the report was provided, along with appeal rights to Education Specialist, Vanessa Guzman and Program Specialist, Vicky Bermudez.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2024
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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