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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006261
Report Date: 06/23/2023
Date Signed: 06/23/2023 03:44:51 PM

Document Has Been Signed on 06/23/2023 03:44 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:VAN WIG HEAD START/STATE PRESCHOOLFACILITY NUMBER:
198006261
ADMINISTRATOR:JOANNE MENDEZFACILITY TYPE:
850
ADDRESS:1151 VAN WIG AVE.TELEPHONE:
(626) 931-8000
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 0DATE:
06/23/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Rosie DucoingTIME COMPLETED:
04:30 PM
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On 6/23/2023 Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced POC (plan of correction) inspection to ensure the Type B deficiency cited on 06/22/2023 the case management has been cleared. A COVID risk assessment was conducted upon entry. LPA met with Child Development Director, Rosie Ducoing, who have a census of 0 children and no staff present at the facility due to summer break from June 6 - August 14, 2023. LPA then drove to Flanner Head Start Preschool (191570934) facility located 2 minutes away to complete the report.

Director provided LPA a copy of the report showing lead exceedances below 5.5 ppb.

Sample Site J - Sink Faucet inside children’s bathroom located between Room I and H ( 0.83 UG/L)
Sample Site E – Sink Faucet small children’s combined sink located in Room H (0.71 UG/L)
Sample Site F – Sink Faucet small children’s combined sink located in Room H (0.76 UG/L)

LPA cleared the deficiency on this date and provided a copy of the Licensing Report to the Director. LPA also issued POC clearance letter during the visit.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted, appeal rights given, and a copy of the report was reviewed and given to acting Director, Rosie Ducoing.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2023
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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