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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006261
Report Date: 09/12/2024
Date Signed: 09/12/2024 02:47:44 PM

Document Has Been Signed on 09/12/2024 02:47 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/
DIRECTOR:		JOANNE MENDEZFACILITY TYPE:
850
ADDRESS:1151 VAN WIG AVE.TELEPHONE:
(626) 931-8000
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 72TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
09/12/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Ms. Socorro Ruiz, Ms. Mercedes Gomez and Lucy BarceloTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 9/12/2024 @ 11:00 am Licensing Program Analyst, (LPA) Carolyn Tuba conducted an unannounced case management inspection visit for an incident that was reported by the facility. Covid Risk Assessment was conducted. LPA met with Staff, Socorro Ruiz. Child Development Supervisor, Mercedes Gomez arrived shortly after. LPA obtained a census of 11 children in care with 2 staff and 1 additional adult.

The incident was reported to the Department within the required 24 hours of occurrence.

The incident occurred on 9/5/2024 and pertains to the personal rights of a child reported by the facility on 9/5/2024. The LPA interviewed Staff #1 (S1) and Staff #2 (S2). LPA requested a copy of the Parent Handbook and is being sent via email by the Program Supervisor, Lucy Barcelo. LPA learned there are photos of the incident, but since Director, Rosie Ducoing was not available, photos will need to be obtained at a later time. The facility is conducting their own investigation. LPA attempted to conduct interview with Child #1 (C1) but child has been relocated to another facility within the Bassett Unified School District and was not available.

No citations have been issued at this time.

Notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Program Supervisor, Lucy Barcelo.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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