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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870758
Report Date: 02/21/2023
Date Signed: 02/21/2023 11:42:06 AM

Document Has Been Signed on 02/21/2023 11:42 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ONE HUNDRED SECOND STREET EARLY EDUCATION CENTERFACILITY NUMBER:
191870758
ADMINISTRATOR:VENUS STOVALLFACILITY TYPE:
850
ADDRESS:1925 EAST 102ND STREETTELEPHONE:
(323) 569-8159
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY: 112TOTAL ENROLLED CHILDREN: 112CENSUS: DATE:
02/21/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Venus Stovall, PrincipalTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced case management inspection on 2/21/23 at 9:45am. Upon arrival, LPA met with Venus Stovall, Principal. There were 85 children present during inspection.

On 2/10/23, Principal submitted an unusual incident report to the Department regarding an incident that facility was made aware of on the same day. Incident reported stated that a child's personal rights may have been violated.

LPA obtained Children's Roster, Staff Roster, Sign in/out sheets, incident report and other pertinent documentation. At this time the incident needs requires further investigation.

No deficiencies will be cited today 2/21/23.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days.

Exit interview was conducted with Venus Stovall, Principal, during which appeal rights were explained.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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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