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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018919
Report Date: 04/12/2024
Date Signed: 04/12/2024 02:35:15 PM

Document Has Been Signed on 04/12/2024 02:35 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 HAWAIIAN GARDENS EARLY LEARNING CENTERFACILITY NUMBER:
198018919
ADMINISTRATOR:FABIOLA HERNANDEZFACILITY TYPE:
850
ADDRESS:22150 WARDHAM AVE.TELEPHONE:
(562) 429-3115
CITY:HAWAIIAN GARDENSSTATE: CAZIP CODE:
90716
CAPACITY: 64TOTAL ENROLLED CHILDREN: 38CENSUS: 25DATE:
04/12/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Fabiola Da RosaTIME COMPLETED:
03:00 PM
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On 04/12/2024, about 1:30PM, Licensing Program Analysts (LPAs) T. Tran and P. Bowden conduct an unannounced case management for Lead at the above licensed facility. Upon arrival, LPAs met with Lead Teacher, Fabiola Da Rosa and we toured the facility. LPAs observed proper care and supervision.

The purpose of today's inspection was to go over the water lead test results received on 10/14/22. Results show four water sources had action level exceedance of lead. Classroom 1, 2, 3 water fountain, and office's sink had a lead result of 7.03 and higher. Per facility representative, this result was wrongly tested. On 12/06/22, facility had retested the water sources and the results show 5.0 and below.

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, Fabiola Da Rosa.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2024
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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