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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017132
Report Date: 11/13/2024
Date Signed: 11/13/2024 09:48:17 AM

Document Has Been Signed on 11/13/2024 09:48 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:4TH STREET EARLY EDUCATION CENTERFACILITY NUMBER:
198017132
ADMINISTRATOR/
DIRECTOR:		IRENE SANTILLANFACILITY TYPE:
850
ADDRESS:421 S. HILLVIEW AVENUETELEPHONE:
(323) 266-4024
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 144TOTAL ENROLLED CHILDREN: 82CENSUS: 73DATE:
11/13/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Kathy Romo, Principal TIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced poc inspection (plan of correction) to insured that the Type A deficiency cited on 10/29/2024 has been cleared. LPA met with Principal Kathy Romo, who guided analysts on a tour of the facility. Census was taken.

The following was observed:

- Staff meeting was conducted on 11/5/2024- meeting agenda, power point and declarations were obtained.

- The LIC 9224 Acknowledgement forms was observed to be on files reviewed

LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA cleared deficiency on this date. POC letter was provided on this date.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Principal Kathy Romo.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
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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