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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493538
Report Date: 09/03/2024
Date Signed: 09/03/2024 12:53:21 PM

Document Has Been Signed on 09/03/2024 12:53 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:EVERGREEN EARLY LEARNING HEAD STARTFACILITY NUMBER:
197493538
ADMINISTRATOR/
DIRECTOR:
CARDENAS, LAURAFACILITY TYPE:
850
ADDRESS:312 S OLEANDER AVENUETELEPHONE:
(323) 421-1100
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 80TOTAL ENROLLED CHILDREN: 57CENSUS: 53DATE:
09/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Candice BondadTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analysts (LPA) T. Tran made an unannounced visit at Evergreen Early Learning Head Start to conduct a Case Management Incident occurred on 8/19/2024. The Monterey Park Southwest Office received the writing report on 08/19/2024 regarding a child in care had a head injury that required medical care. Upon arrival, LPA met with site supervisor, Candice Bondad and toured the facility. LPA observed proper care and supervision and ratio.

LPA completed files review for children and staff. LPA obtained child's document and personnel report. Interviews were conducted with staff, children, and other. Based on the interviews and record reviewed, on the day of the incident, there were two staff supervised 14 children. During outside play, staff observed C1 was play with a group of friends. C1 ran and stumbled then hit the head on the corner of the playhouse. Child sustained cut on the left side near the hairline area. Staff immediately provided first aid and parent was contacted. Child returned to school on 8/21/24 without any restrictions from the doctor. Based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.

No deficiency was found during today's inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Candice Bondad.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/03/2024
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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