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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016407
Report Date: 01/07/2025
Date Signed: 01/07/2025 03:03:28 PM

Document Has Been Signed on 01/07/2025 03:03 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CII/OTIS BOOTH CDCFACILITY NUMBER:
198016407
ADMINISTRATOR/
DIRECTOR:
PRISCILLA ALMEJOFACILITY TYPE:
850
ADDRESS:424 N. LAKE STREETTELEPHONE:
(213) 260-7717
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 40TOTAL ENROLLED CHILDREN: 31CENSUS: 0DATE:
01/07/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Priscilla Almejo, DirectorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to an incident that was reported to the Department on 12/19/2024. LPA met with Director Priscilla Almejo who guided LPA on a tour of the facility. According to Director there are no children present at the time of the visit and children will return from winter break on 1/8/2025.

On December 19th, 2024, an incident was reported to the Department via Phone by the facility who reported a child requiring medical treatment.



All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incident reported to the Department.

During the inspection, LPA Valenzuela conducted interviews with six staff. Regarding the incident no disclosures were made on this date regarding personal rights violations. First aid was administered and parent of Child #1 (C1) was notified. C1 was taken by parent for medical treatment. Per Director, C1 has not returned to the facility due to the facility still in winter break. LPA asked for copies of ouch report, and C1 doctor's report- Director provided copies of the documents to LPA.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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

Exit interview conducted and report was reviewed with facility representative, Priscilla Almejo.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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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