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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018055
Report Date: 11/13/2023
Date Signed: 11/13/2023 10:56:48 AM

Document Has Been Signed on 11/13/2023 10:56 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CHILDRENS INSTITUTE/IMPERIAL COURTSFACILITY NUMBER:
198018055
ADMINISTRATOR:AKIDA CROSBYFACILITY TYPE:
850
ADDRESS:11425 GORMAN AVE.TELEPHONE:
(213) 385-5100
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY: 24TOTAL ENROLLED CHILDREN: 19CENSUS: 10DATE:
11/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ema IkobiTIME COMPLETED:
11:20 AM
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Licensing Program Analyst, (LPA) T. Tran, arrived at the above licensed facility to conduct a case management incident visit that was self-reported on 10/17/23. Facility had confirmed there were three cases head lice outbreak between 10/16/23-1017/23. LPA met with Teacher Floater, Ema Ikobi and toured the center inside and outside.

Per facility representative, upon arrival, staff conducted a health screening and observed children with head lice, each child were sending home with a shampoo kit. Facility had reported to the health department and all enrolled families were notified. The staffs were given specific instructions with regarding to cleaning such as shampoo all carpet areas, disinfecting the toys, equipment, tables, chairs, floors, stuff animals, and napping sheets etc.

LPA reviewed the children records and obtained children record and facility LIC 500. Per staff none of the children were hospitalized and they all had cleared to return to school. No new cases occurred. LPA inspected the facility and observed the facility to be clean and orderly.

No deficiency was cited at this time. 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, Ema Ikobi.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2023
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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