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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020251
Report Date: 07/02/2024
Date Signed: 07/02/2024 04:10:17 PM

Document Has Been Signed on 07/02/2024 04:10 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 PRESCHOOLFACILITY NUMBER:
198020251
ADMINISTRATOR/
DIRECTOR:		MALI RANDFACILITY TYPE:
850
ADDRESS:1423 TAMARIND AVETELEPHONE:
(323) 469-3706
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 27DATE:
07/02/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:26 PM
MET WITH:Mali Rand, DirectorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On July 2, 2024, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced Case Management Inspection – Plan of Correction at the above facility. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with Director, Mali Rand who guided LPA on a tour of the facility. LPA observed 27 children in care with 4 staff. The purpose of this inspection is to ensure that the facility is in compliance with Title 22 Regulations and the deficiencies cited on 06/24/2024 were corrected.

Licensing staff observed and reviewed the following:

· Director held a staff meeting on 06/20/2024 (prior to the deficiency) and on 07/01/2024 to address the incident and deficiency.

· Director has reported the incident to LPA via email on 06/28/2024.

Letters of Deficiencies Citations Cleared were provided for deficiencies corrected.

Director completed a declaration form indicated that all video/audio footage that was recorded on 06/24/2024 was deleted and was not reviewed by the director or any one else prior to being deleted and will not be resurfaced.

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. Failure to maintain posting as required will result in a civil penalty of $100.00

An exit interview was conducted, and a copy of this report was provided to director, Mali Rand along with Appeal Rights.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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