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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870904
Report Date: 03/04/2025
Date Signed: 03/04/2025 11:05:21 AM

Document Has Been Signed on 03/04/2025 11:05 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:WADSWORTH AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870904
ADMINISTRATOR/
DIRECTOR:		HUMBERTO BENITEZFACILITY TYPE:
850
ADDRESS:1047 EAST 41ST STREETTELEPHONE:
(323) 232-0581
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 111TOTAL ENROLLED CHILDREN: 111CENSUS: 77DATE:
03/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Michael Lopez BreauxTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On 3/4/25 at 10:20 AM Licensing Program Analysts (LPA) Claudia Kam and Christine Nolan conducted an Unannounced Case management Inspection to follow up on an incident that was reported to the Department. Upon arrival, LPAs announced purpose of inspection and met with Facility Representative, Michael Lopez Breaux, who granted entry to facility. Census was taken.

On 12/20/24, an incident was reported to The Department where a child sustained an injury while in care. The facility reported this incident to the Department within the required 24 hours and submitted written report within seven days.

During this inspection LPAs interviewed staff, observed indoor play area where incident took place, and observed child named in report. Principle informed Licensing that a child was transitioning to rug time and did a flip and injured his hand. Principle states first aid was applied immediately and guardians contacted. LPAs observed classroom area to be free of hazards. LPAs observed child present at the facility unhindered with no cast as cast had been removed. Based on the information obtained and LPAs observation LPAs determined there was adequate supervision.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 3/4/2025.


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

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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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