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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020953
Report Date: 02/06/2025
Date Signed: 02/06/2025 11:32:21 AM

Document Has Been Signed on 02/06/2025 11:32 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BRELLA HOLLYWOODFACILITY NUMBER:
198020953
ADMINISTRATOR/
DIRECTOR:		REBECCA KELLYFACILITY TYPE:
850
ADDRESS:909 N. ORANGE DR.TELEPHONE:
(213) 300-5962
CITY:LOS ANGELESSTATE: CAZIP CODE:
90038
CAPACITY: 45TOTAL ENROLLED CHILDREN: 153CENSUS: 39DATE:
02/06/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Rebecca Kelly, Center DirectorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to an incident that was reported to the Department on 12/18/2024. LPA met with Principal Christina Ramaya who guided LPA on a tour of the facility. Census was taken.

On December 18th, 2024, an incident was self-reported to the Department via Phone by the facility who reported that a staff violated a child's personal rights while in care.



All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incidents reported to the Department.

During the inspection, LPA Valenzuela conducted interviews with two (2) staff. Per Director, Staff #3 (S3) disclosed to Director that there have been several incidents involving Staff #4 (S4) with Child #1 (C1) being handle roughly on 12/12/2024 and 12/16/2024. Director provided video footage of incidents to LPA to observe via Director's laptop..

During the observation of the video footage for 12/12/2024 at 10:00 a.m., LPA Valenzuela observed S4 grabbed C1's arm to move C1 towards the rug then S4 pushed C1's body onto the ground. Several seconds into the video, LPA observed S4 pull C1 by the arm causing C1 to be lifted off the floor in a rapid motion that caused C1 to cry.

During the observation of the video footage for 12/16/2024 at 11:19 a.m., LPA Valenzuela observed C1 on the rug with other children when S4 approached C1 and grabbed their wrist and lifted C1 causing them to stand up from the seating position. S4 continued to hold onto C1's wrist and took them towards the changing table to check their diaper.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BRELLA HOLLYWOOD
FACILITY NUMBER: 198020953
VISIT DATE: 02/06/2025
NARRATIVE
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Per Director, they conducted training from 12/19 to 12/23/2024 with staff on lifting and holding policy, children's personal rights, and nonviolent communication after the incidents were disclosed to Director.
Director provided LPA copies of investigation notes and training attendance. LPA was unable to interview S3 and S4 as they no longer work at the school.

Based on LPA's interviews and observation, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

LPA cleared deficiency and provided proof of correction letter on this date.

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

Exit interview conducted and report was reviewed with facility representative, Rebecca Kelly.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 02/06/2025 11:32 AM - It Cannot Be Edited


Created By: Saul Valenzuela On 02/06/2025 at 11:03 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BRELLA HOLLYWOOD
FACILITY NUMBER: 198020953

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/06/2025
Section Cited
CCR
101223(a)(1)

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101223 Personal Rights
(1) To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement is not met as evidenced by:
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Per Director, they had a staff meeting to review Personal Rights, lifting and holding policy, and nonviolent coomunication. Signed attendance sheet and copy of meeting agenda were provided to LPA. Per Director, S4 is no longer employed by the facility.
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Based on observation and interview, facility did not sure that a child was accorded dignity, as camera footage showed S4 violating C1 personal rights in two different occassions. This is a potential risk to the health, safety, and personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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