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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000225
Report Date: 06/12/2024
Date Signed: 06/12/2024 03:36:05 PM

Document Has Been Signed on 06/12/2024 03:36 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:BASSETT HEAD START/ERWINFACILITY NUMBER:
198000225
ADMINISTRATOR/
DIRECTOR:		R. DUCOING/Y. OROZCOFACILITY TYPE:
850
ADDRESS:943 N. SUNKIST AVENUETELEPHONE:
(626) 931-3161
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 168TOTAL ENROLLED CHILDREN: 1CENSUS: 24DATE:
06/12/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:10 PM
MET WITH:Mercedes Gomez & Gladys VargasTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On June 12, 2024, at 2:10 pm Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an incident that was self-reported and submitted by the facility that occurred on 5/14/2024. Covid risk assessment was conducted. LPA met with staff and LPA called Child Development Director, Rosie Ducoing who sent over Child Development Supervisors, Mercedes Gomez & Gladys Vargas who arrived at approximately 2:30 pm. LPA observed and took a census of 26 children with 4 staff during naptime.

The incident was reported to the Department within the required 24 hours of occurrence. The incident consisted with a child reported to their parent that a staff member had allegedly grabbed child by the armpit. The facility conducted their own investigation and have not concluded their findings. LPA received facility roster. Mercedes Gomez will be sending LPA via email any statements and staff information.

During this investigation, LPA was unable to conduct interview with Child #1 (C1) due to them napping. Staff and witnesses were not available, however LPA interviewed Mercedes Gomez.

No citations have been issued at this time.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Child Development Supervisor, Mercedes Gomez.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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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