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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014197
Report Date: 03/14/2024
Date Signed: 03/14/2024 06:01:09 PM

Document Has Been Signed on 03/14/2024 06:01 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CHILDREN'S BUREAU FAMILY CENTER AT MAGNOLIA PLACEFACILITY NUMBER:
198014197
ADMINISTRATOR:MARY HELEN VASQUEZFACILITY TYPE:
850
ADDRESS:1910 MAGNOLIA AVENUETELEPHONE:
(213) 342-0101
CITY:LOS ANGELESSTATE: CAZIP CODE:
90007
CAPACITY: 105TOTAL ENROLLED CHILDREN: 105CENSUS: DATE:
03/14/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Paquita Monsorri, Site DirectorTIME COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of a Case Management - Lead Exceedance visit. LPA announced purpose of the visit and was granted entry into the facility by Site Director Paquita Monsorri who guided LPA on tour of facility. There were 16 children and 5 staff present during inspection.

Director was able to discuss understanding of the assembly bill regarding lead testing of facilities. LPA provided a copy of lead testing mandate if Director wanted to add a copy to her lead exceedeance folder.

Facility provided LPA White with a copy of the facility sketch of the water sourcing throughout the facility. LPA White observed the following remediation and corrections:

Classroom 305 (Sample Site: L - 11) bubbler faucet has been completely removed. Classroom not in use due to low enrollment.

Classroom 306
  • (Sample Site: J - .75) Site corrected by retesting on 2/10/2023
  • (Sample Site: K - 30.00) bubbler faucet has been completely removed. Classroom is not used due to low enrollment.

Classroom 307 (Sample Site: I - 11) bubbler faucet has been completely removed.

Classroom 308 (Sample Site: H - 6.8)bubbler faucet has been completely removed.

...................................................................Report Continues 1 of 2 Pages..................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S BUREAU FAMILY CENTER AT MAGNOLIA PLACE
FACILITY NUMBER: 198014197
VISIT DATE: 03/14/2024
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Classroom 309 (Sample Site: F - 14) bubbler faucet has been removed. Classroom is not used due to low enrollment.

Classroom 310A (Sample Site: E - 8.6) bubbler faucet removed. Classroom not in use due to low enrollment.
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Director states that provide water bottles for the children, and a pitcher of water and disposable cups. LPA observed ample amount of water supply for children in care.

Based on the observations of classrooms and water sources, interviews with the director and facility manager, and review of facility sketch the facility is in compliance with lead testing mandate.

There are no deficiencies being cited today in accordance with Title 22.

The Notice of Site Visit (LIC 9213 –must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview conducted with Site director Paquita Mansouri and a copy of Appeal Rights (LIC 9058) was discussed.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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