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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006095
Report Date: 03/13/2023
Date Signed: 03/13/2023 09:35:11 AM

Document Has Been Signed on 03/13/2023 09:35 AM - 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:PICO GARDENFACILITY NUMBER:
198006095
ADMINISTRATOR:MARIA CASTILLOFACILITY TYPE:
850
ADDRESS:1500 E. 4TH STREETTELEPHONE:
(323) 264-3649
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 51TOTAL ENROLLED CHILDREN: 48CENSUS: 26DATE:
03/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Maria Castillo TIME COMPLETED:
09:50 AM
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Licensing Program Analyst (LPA) Judy Mora conducted a case management inspection due to an incident that occurred at the facility on 01/30/23. LPA met with Center Manager, Maria Castillo. LPA was guided on a tour of the classrooms by Maria Castillo. LPA conducted interview and obtained documentation during this visit.

The incident that occurred was reported to the Department within the required 24 hours of occurrence. The incident which occurred consisted of a biting incident.

Based on all information obtained and interview conducted with the Center Manager who observed the incident; no follow-up is necessary regarding the incident. Facility staff are addressing the issue on a case by case basis and a plan of action is in place. The facility staff could not have done anything to prevent the incident from occurring and preventative measures are being taken in order to prevent similar incidents. LPA observed that a similar incident has not occurred since 01/30/23.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

There were no deficiencies observed in regards to today's inspection.

Exit interview was conducted with Center Manager, Maria Castillo. Appeal rights explained & provided.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2023
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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