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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890434
Report Date: 11/28/2022
Date Signed: 11/28/2022 01:37:23 PM

Document Has Been Signed on 11/28/2022 01:37 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:MONTE VISTA EARLY EDUCATION CENTERFACILITY NUMBER:
191890434
ADMINISTRATOR:BARBARA PAGEFACILITY TYPE:
850
ADDRESS:5509 ASH STREETTELEPHONE:
(323) 258-3842
CITY:LOS ANGELESSTATE: CAZIP CODE:
90042
CAPACITY: 162TOTAL ENROLLED CHILDREN: 62CENSUS: 52DATE:
11/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Barbara Walker, Principal TIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management inspection due to an incident that occurred on November 10th, 2022 Due to COVID- 19 precautionary measures were taken, appropriate PPE was used. LPA met with Principal Barbara Walker, who guided LPA on a tour of the facility. There were 52 children observed to be present at the facility during LPAs arrival.

LPA Roxana Lopez conducted interviews and obtained documentation during visit.

The incident that occurred on 11/10/2022 was reported to the facility representative on 11/10/2022 and the facility reported to the Department on 11/14/2022, via telephone.

Information reported to the Department indicated that Staff #5 violated Child #1’s personal rights.



Based upon information received from the interviews conducted by LPA Lopez on 11/28/2022 it was determined that the personal rights of Child #1 were violated by Staff #5.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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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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: MONTE VISTA EARLY EDUCATION CENTER
FACILITY NUMBER: 191890434
VISIT DATE: 11/28/2022
NARRATIVE
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 During this investigation, disclosures were made by Child # 1 disclosing that their personal rights were violated by Staff # 5 and are scared of them. Child # 4 and # 5 disclosed that they have witnessed Staff # 5 violate a child's personal right and that they are scared of Staff # 5. Disclosures were made by staff who confirm that Staff #5 has a history of violating children's personal rights- Staff # 3 disclosed observing Staff # 5 violating a child's personal rights.

This poses an immediate health and safety risk to children in care. Title 22 Regulation Section 101223 Personal Rights states (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.

The following deficiency listed on the attached LIC 809 deficiencies page is being cited in accordance with California Code of Regulations Title 22.

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

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC809 (FAS) - (06/04)
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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: MONTE VISTA EARLY EDUCATION CENTER
FACILITY NUMBER: 191890434
VISIT DATE: 11/28/2022
NARRATIVE
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LPA Roxana Lopez informed facility representative Principal Barbara Walker that this report dated 11/28/2022 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Roxana Lopez informed the facility representative to provide a copy of this licensing report dated 11/28/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit and a copy of this report was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with facility representative, Principal Barbara Walker



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

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/28/2022 01:37 PM - It Cannot Be Edited


Created By: Roxana Lopez On 11/28/2022 at 01:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTE VISTA EARLY EDUCATION CENTER
FACILITY NUMBER: 191890434

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/28/2022
Section Cited
CCR
101223(a)(3)

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101223-Personal Rights: (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting...
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Per Principal Wlaker- they will request for Staff # 5 to be removed from the school- make sure all documentations and trainings are provided in the language necessary. Principal will submit proof of meeting agenda with signature of staff present.
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This requirement is not met as evidenced by: Based on interviews conducted by it was determined that the personal rights of Child #1 were violated by Staff #5 This poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2022


LIC809 (FAS) - (06/04)
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