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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014691
Report Date: 12/09/2022
Date Signed: 12/09/2022 09:13:32 AM

Document Has Been Signed on 12/09/2022 09:13 AM - 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:GOOD BEGINNINGS HEAD STARTFACILITY NUMBER:
198014691
ADMINISTRATOR:LINDA LUNAFACILITY TYPE:
850
ADDRESS:1839 S. HOOVER STREETTELEPHONE:
2137441347
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 60TOTAL ENROLLED CHILDREN: 48CENSUS: 21DATE:
12/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Ruzanna DavitanTIME COMPLETED:
09:30 AM
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On 12/9/2022, about 8:30 AM, Licensing Program Analyst (LPA) T. Tran conducted a case management visit at PACE- Good Beginnings Head Start to deliver the Decision and Order of Exclusion. About 8:40 AM, LPA met with Ruzanna Davitan, Regional Site Director and we toured the facility.

Based on evidence obtained during today’s visit, LPA has verified the individual was never hired to work at this facility. LPA has advised the licensee to disassociate the individual from their roster. LPA obtained the LIC 500.

LPA had reviewed and provided the Decision and Order to the facility representative.

Exit interview conducted and report was given to the facility representative, Ruzanna Davitan.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2022
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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