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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411901
Report Date: 06/12/2023
Date Signed: 06/12/2023 03:18:39 PM

Document Has Been Signed on 06/12/2023 03:18 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MAPLE PRIMARY CENTER STATE PRESCHOOLFACILITY NUMBER:
197411901
ADMINISTRATOR:SHARYN CLARKFACILITY TYPE:
850
ADDRESS:3601 S. MAPLE AVE. RM. 100 105TELEPHONE:
(323) 232-0984
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
06/12/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Sharyn Clark, PrincipalTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced follow-up case management inspection on 6/12/23. The purpose of this visit is to address two incidents that were reported to the department. Upon arrival, LPA met with Sharyn Clark, Principal. There were no children present due to summer vacation.

On 6/2/23, Principal submitted an unusual incident report to the Department regarding an incident that occurred that same day. Incident report stated that an alleged personal rights violation occurred between Staff One (S1) and Child One (1). Upon arrival Principal notified LPA that she was made aware on 6/6 of another alleged incident regarding a personal rights violation between Staff Two (S2) and Child Two (C2).

LPA conducted interviews and gathered pertinent information regrading the alleged incidents. LPA did not receive disclosers from adults or children that the incident reported on 6/2/23 occurred. Staff state that the discipline used at the facility is redirection and positive behavior supports. The children are redirected verbally when they do not follow direction. Physical redirection, such as hand holding, occurs when children are going to hurt themselves or others.

LPA received no disclosures regarding the alleged incident on 6/6. Per staff, S2 was in an Individual Education Plan (IEP) meeting, outside of the classroom, during the AM program and did not interact with C2. S2 returned to the classroom at 10:45am to dismiss the children at 11AM. Room 105 had a substitute Teacher in their place.

No deficiencies will be cited today 6/12/23.

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

Exit interview was conducted with Sharyn Clark, Principal.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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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