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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019281
Report Date: 04/29/2022
Date Signed: 04/29/2022 03:14:11 PM

Document Has Been Signed on 04/29/2022 03:14 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HAPPY BIRCH PRESCHOOL- TAMARINDFACILITY NUMBER:
198019281
ADMINISTRATOR:SOLEDAD GUEVARAFACILITY TYPE:
850
ADDRESS:1429 TAMARIND AVETELEPHONE:
(323) 380-7311
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 30DATE:
04/29/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Mali Rand - AdministratorTIME COMPLETED:
03:15 PM
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Licensing Program Analysts (LPAs) Steven Tung and Mireya Garcia conducted an un-annouced case management to investigate an unusual incident regarding two children that occurred on 3/18/22 and was the report received on 3/23/22. Due to COVID-19 risk assessment was conducted and appropriate PPE material was used. LPAs met with Administrator Mali Rand who guided analyst on a tour of the facility.

As part of the investigation LPAs obtained copies of the children's roster, Daily Activity schedule, reviewed children's files, and interviewed staff and a child. The investigation will continue to conduct interviews and gather additional documentation.

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

Exit interview was conducted with Administrator Mali Rand. A copy of this report was provided.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2022
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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