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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890434
Report Date: 08/15/2023
Date Signed: 08/15/2023 01:39:47 PM

Document Has Been Signed on 08/15/2023 01:39 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MONTE VISTA EARLY EDUCATION CENTERFACILITY NUMBER:
191890434
ADMINISTRATOR:BARBARA A. WALKERFACILITY TYPE:
850
ADDRESS:5509 ASH STREETTELEPHONE:
(323) 258-3842
CITY:LOS ANGELESSTATE: CAZIP CODE:
90042
CAPACITY: 162TOTAL ENROLLED CHILDREN: 162CENSUS: 52DATE:
08/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Principal Barbara Walker TIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management- Incident inspection at the above facility on 08/15/23 at 08:15 a.m. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with Principal, Barbara Walker who guided LPA on a tour of the facility. Census was taken.

The purpose of this inspection is to follow up on an unusual incident report that occurred on 07/13/23 and was reported to the Department by the facility on 07/18/23, a parent alleges that a child's personal rights were violated while in care by Staff #1.

During this investigation, LPA interviewed, Staff 1 (S1-4), children 1 (C1-3), and obtained a copy of facility roster.

At this time, there are no deficiencies warranted for the unusual incident report, however, deficiencies are being cited for not reporting on time. The following deficiency listed on the attached LIC 809D (deficiency page) is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative, a civil penalty of $100 can be assessed.

Exit Interview was conducted, and appeal rights were given, along with a copy of this report was provided to the Principal, Barbara Walker.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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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Document Has Been Signed on 08/15/2023 01:39 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 08/15/2023 at 01:03 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: 08/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2023
Section Cited
CCR
101212(d)(1)(c)

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Reporting Requirements: Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department..(C) Any unusual incident... or safety of any child
This evidence was not met by:
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Per Principal, an Unusual Incident Report procedure was placed on the employee board for all employees to follow for future Unusual Incident Reports. LPA observed the procedure in place.
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Facility did not report an unusual incident report that occurred on 07/13/23 to the Department within the required 24 hours. Unusual Incident report was received on 07/18/23.
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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:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2023


LIC809 (FAS) - (06/04)
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