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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890351
Report Date: 08/10/2023
Date Signed: 08/10/2023 01:18:45 PM

Document Has Been Signed on 08/10/2023 01:18 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GATES STREET EARLY EDUCATION CENTERFACILITY NUMBER:
191890351
ADMINISTRATOR:SCARLETT RAMIREZ-HOLGUINFACILITY TYPE:
850
ADDRESS:2306 THOMAS STREETTELEPHONE:
(323) 222-0277
CITY:LOS ANGELESSTATE: CAZIP CODE:
90031
CAPACITY: 114TOTAL ENROLLED CHILDREN: 67CENSUS: 46DATE:
08/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Lead Teacher Ms. Dominguez TIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced Case Management inspection due to incidents that were reported to the Department on June 9th, 2023 (2 incidents), June 16th, 2023 and July 14th, 2023. A COVID 19 risk assessment was conducted. LPA met with Head Teacher Sandy Dominguez who guided LPA on a tour of the facility. Principal, Scarlett Ramirez-Holguin later arrived during this inspection. Census was taken.


On June 9th, 2023, two incidents were self reported to the Department via Email by the facility who reported two different children were injured while in care.

On June 16th, 2023, one incident was self reported to the Department via Email by the facility who reported a parent alleges that a child's personal rights were violated while in care.

On July 14th, 2023, one incident was self reported to the Department via Email by the facility who reported a grandparent alleges that a child's personal rights were violated while in care.

All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incidents reported to the Department.

During the inspection, LPA Lopez conducted interviews with Principal, four (4) staff and four (4) day care children. The two injuries report were observed by staff, first aid was administered, children did not required medical attention and were back the following day. No disclosures were made on this date regarding personal rights violations.-------------------------- pg. 1 of 2 -----------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GATES STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191890351
VISIT DATE: 08/10/2023
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 LPA did obtained copies of staff declarations and Unusual Incident Reports submitted on this date.

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

Exit interview conducted and report was reviewed with facility representative, Scarlett Ramirez-Holguin.

------------------------------------------ pg. 2 of 2 -------------------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
LIC809 (FAS) - (06/04)
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