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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006098
Report Date: 06/21/2021
Date Signed: 06/21/2021 03:33:40 PM

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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:RANCHO LOS AMIGOS CHILDREN'S CENTERFACILITY NUMBER:
198006098
ADMINISTRATOR:HELIA CASTELLONFACILITY TYPE:
850
ADDRESS:7755 GOLONDRINAS STREETTELEPHONE:
(562) 401-7981
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:59CENSUS: 34DATE:
06/21/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Helia Castellon, DirectorTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) T. Tran arrived at Rancho Los Amigos Children's Center to conduct a Case Management inspection that was self-reported on 05/11/2021. The Monterey Park South West Child Care Regional Office received the incident report on 5/11/2021.

About 1:20 PM LPA toured the facility. LPA completed the files reviews and obtained child's document. LPA conducted interviews with staff and other. Per center staff, on the day of the incident there were 2 staff with 10 children in care. During outdoor play, C1 was running up the steps then fell hit her nose. Staff immediately attended to child and provided first aid care. Parent was contacted. Child had returned to school the next without any doctor restrictions. Based on the available information, this incident was not result in the Title 22 Regulations for Lack of Care and Supervision violation. No deficiency was cited.

The content of this report was read and discussed in detail with the noted person. Appeal Right was provided.

An exit interview was conducted; the notice of site visit must be posted for 30 days upon receipt.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
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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