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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192006337
Report Date: 04/05/2023
Date Signed: 04/05/2023 01:39:23 PM

Document Has Been Signed on 04/05/2023 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CENTRO DE ALEGRIAFACILITY NUMBER:
192006337
ADMINISTRATOR:VERONICA HERRERAFACILITY TYPE:
850
ADDRESS:420 N. SOTO STREETTELEPHONE:
(323) 685-8501
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 62TOTAL ENROLLED CHILDREN: 50CENSUS: 28DATE:
04/05/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Maricela Guzman TIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Judy Mora conducted a case management inspection due to two incidents that occurred at the facility on 01/12/23 (Incident #1) and 03/28/23 (Inciednt #2). LPA met with Program Manager, Maricela Guzman, who guided LPA on a tour of the facility. Director, Veronica Herrera, arrived during this inspection. LPA conducted interviews and obtained documentation during this visit.

Incident #1: The incident that occurred was reported to the Department within the required 24 hours of occurrence. The incident which occurred consisted of C1 being given the incorrect milk, causing them to have a mild allergic reaction on site.

Based on the information obtained from staff interviews and records obtained, the facility did not provide C1 with the correct milk. The child's allergies were listed on the LIC 701, Physician's Report dated 10/20/21. Although, staff disclosed that the incorrect milk was served on accident, this was an immediate risk to the health and safety of child #1. The facility was in violation of child #1's Personal Rights, each child shall be accorded safe, healthful and comfortable accommodations.

Incident #2: The incident that occurred was reported to the Department within the required 24 hours of occurrence. The incident which occurred consisted of a child injury.

LPA observed the area where the incident occurred. The apparatus was observed to be age appropriate. LPA recommended that the facility place a cushioning material under the apparatus where the child was hurt to prevent any similar injury.

Based on all information obtained and interview conducted with the Program Manager; no follow-up is necessary regarding incident #2. The facility staff could not have done anything to prevent the incident from occurring. The child did not need any stiches or glue on the injury. Child returned to the facility the following day.

*REPORT CONTINUES ON NEXT PAGE
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2023
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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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: CENTRO DE ALEGRIA
FACILITY NUMBER: 192006337
VISIT DATE: 04/05/2023
NARRATIVE
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Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care for up to one year.

A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Director, Veronica Herrera. Appeal rights explained & provided.

*END OF REPORT

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/05/2023 01:39 PM - It Cannot Be Edited


Created By: Judy Mora On 04/05/2023 at 01:07 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: CENTRO DE ALEGRIA
FACILITY NUMBER: 192006337

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/06/2023
Section Cited
CCR
101223(a)(2)

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Personal Rights
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by the incident that occurred on 01/12/23, when C1 was given the incorrect milk causing
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Director states they read nutrition labels on all items purchased to, they changed the child's cup which is colored to make sure it is the correct milk. There is a menu and substitutions listed. Pictures of milk with children's name. Written statement will be sent to LPA. Meeting was held with the nutritionist and staff.
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him to have a mild allergic reaction. This was an immediate risk to the health and safety of this child.
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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:Claudia Guangorena
LICENSING EVALUATOR NAME:Judy Mora
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2023


LIC809 (FAS) - (06/04)
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