<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011629
Report Date: 07/18/2023
Date Signed: 07/18/2023 05:30:57 PM

Document Has Been Signed on 07/18/2023 05:30 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:AZUSA DISCOVERY CENTERFACILITY NUMBER:
198011629
ADMINISTRATOR:LARA, BELENFACILITY TYPE:
840
ADDRESS:155 W. ARROW HIGHWAYTELEPHONE:
(626) 334-1806
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 17DATE:
07/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Director Belen LaraTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Veronica Martnez Garza conducted an unannounced Case Management inspection due to an incident that was reported to the Department on 07/18/23. LPA met with Director, Belen Lara and Administrator Harshini Maddox who guided LPA on a tour of the facility. Census was taken.

An incident occurred on 07/11/2023 and was not reported to the the Department within the required 24 hours. Incident is in regards to a child's personal rights were violated while in care.




The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Belen Lara.


Page 1 of 1

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/18/2023 05:30 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 07/18/2023 at 04:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AZUSA DISCOVERY CENTER
FACILITY NUMBER: 198011629

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2023
Section Cited
CCR
101212(d)

1
2
3
4
5
6
7
101212 Reporting Requirements
Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day ...following the occurrence of such event.
1
2
3
4
5
6
7
Per Director, unusual incident report will be submitted to the department by POC due date. Director understands that all unusual incident reports will be reported within 24 hours to the department.
8
9
10
11
12
13
14
This requirement is not met as evidenced by:
Facility did not report an alleged child's personal rights violated while in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2