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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 11:30:30 AM

Document Has Been Signed on 03/04/2025 11:30 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 - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:11 AM
MET WITH:Michael Lopez BreauxTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 3/4/25 at 11:11 am Licensing Program Analyst Claudia Kam conducted a Case Management incident inspection at the above facility to follow up on Plan of Corrections.

LPAs completed record review. The purpose of today's inspection was to review files and documentation to clear a plan of correction.

At 11:11 a.m. LPAs observed sign in sheets and completed review of staff files for immunization records. All documentation was complete and meets regulation. Deficiency has been cleared and letter provided to facility representative.


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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