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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019590
Report Date: 08/27/2021
Date Signed: 08/27/2021 03:57:46 PM

Document Has Been Signed on 08/27/2021 03:57 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:EDUCARE LOS ANGELES AT LONG BEACHFACILITY NUMBER:
198019590
ADMINISTRATOR:MARIA HARRIS & SONIA GUTIEFACILITY TYPE:
850
ADDRESS:4840 LEMON AVETELEPHONE:
(562) 422-6618
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 225TOTAL ENROLLED CHILDREN: 0CENSUS: 86DATE:
08/27/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Sonia Gutierrez, Progam SpecialistTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced case management inspection due to an incident that occurred on 07/28/21. LPA met with Sonia Gutierrez, Program Specialist, who guided LPA on a tour of the facility.

The purpose of the inspection was to follow-up on an incident that was reported to the department.

There were 86 children and 20 staff present upon arrival.

LPA conducted interviews and obtained documentation during this visit.

The incident that occurred on 07/28/21, was reported to the Department on 07/28/21, via email. The facility reported the Unusual Incident to the Department within the required 24 hours of occurrence

Information reported to the Department indicated that Staff #1 may have violated Child #1’s personal rights.

Based upon information received from the interviews conducted there is not enough information to determine whether the personal rights of Child #1 were or were not violated. Therefore there were no deficiencies cited during today’s incident inspection

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Exit interview was conducted with Sonia Gutierrez, Program Specialist, including, but not limited to Provider Rights, Appeal Procedures

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2021
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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