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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870752
Report Date: 03/16/2022
Date Signed: 03/16/2022 02:34:33 PM

Document Has Been Signed on 03/16/2022 02:34 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:HOLMES AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870752
ADMINISTRATOR:ELIZABETH OKOROFACILITY TYPE:
850
ADDRESS:1810 EAST FIFTY SECOND STREETTELEPHONE:
(323) 589-6427
CITY:LOS ANGELESSTATE: CAZIP CODE:
90058
CAPACITY: 114TOTAL ENROLLED CHILDREN: 114CENSUS: 37DATE:
03/16/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Elizabeth Okoro, Facility RepresentativeTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced case management inspection on 3/16/22 at 2:00 PM. Upon arrival, LPA met with Elizabeth Okoro, Facility Representative (FR). There were 37 children present during inspection.

On 3/9/2022, FR submitted an unusual incident report to the Department. LPA interviewed staff who witnessed the incident. Children were napping during inspection. LPA reviewed child's records and reviewed pertinent documentation. Per report, Staff One (S1) observed inappropriate behavior involving Child One (C1) and Child Two (C2) during nap time. S1 stated that both children were on their own separate cots at this time. Per S1, as soon as the incident occurred they were able to intervene and have a conversation with each child and the behavior was stopped. FR and S1 stated that both children's parents were informed the same day and the incident was documented. Per FR and S1, there have been actions taken in the classroom to avoid this behavior from occurring again.

Based on information obtained, LPA determined there were no violations that resulted resulted from the incident. No deficiencies were cited today 3/16/22. FR met reporting requirements for this incident.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted with Facility Representative, Elizabeth Okoro.

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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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