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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018034
Report Date: 11/09/2023
Date Signed: 11/09/2023 03:33:08 PM

Document Has Been Signed on 11/09/2023 03:33 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:MAOF HEAD START - LEW SANDS WELTORFACILITY NUMBER:
198018034
ADMINISTRATOR:SONIA GUERREROFACILITY TYPE:
850
ADDRESS:1010 E. 48TH STREETTELEPHONE:
(323) 233-2573
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: DATE:
11/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Linda RuelasTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) T. Tran made an unannounced visit at MAOF Lew Sands Weltor Head Start to conduct a Case Management Incident occurred on 10/04/2023. The Monterey Park South West Office received the writing report on 10/31/2023. Upon arrival, LPA met with teacher Linda Ruelas and toured the facility. LPA observed proper care and supervision.

LPA completed child and staff’s files reviewed. LPA obtained child's document, parent sign-in sheet, and personnel report. Based on the interview conducted with staff and children. At this time, further investigation is needed before concluding the investigation.

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

Exit interview conducted and report was reviewed with the facility representative, Linda Ruelas.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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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