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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021184
Report Date: 02/27/2024
Date Signed: 02/27/2024 03:11:58 PM

Document Has Been Signed on 02/27/2024 03:11 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:EVERGREEN CHILD CARE CENTERFACILITY NUMBER:
198021184
ADMINISTRATOR:SASHA DUARTEFACILITY TYPE:
850
ADDRESS:211 S. EVERGREEN AVENUETELEPHONE:
(323) 263-2816
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 0DATE:
02/27/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Sasha Duarte, Director. TIME COMPLETED:
03:27 PM
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On 2/27/24, Licensing Program Analyst (LPA), Staicy conducted an unannounced POC (plan of correction) inspection to ensure the one (1) -Type B deficiency cited on 2/27/2024 has been cleared. A COVID risk assessment was conducted upon entry. LPA met with Director Sasha Duarte who guided LPA on a tour of the facility, census was taken of 0 children and 1 staff (Director) were observed. The purpose of this inspection is to ensure that the facility is in compliance with Title 22 Regulations and the deficiency cited on 2/27/24 was corrected.

Licensing staff observed and reviewed the following:
1. LPA observed that the Water Drinking Facet in Classroom A is permanently removed and capped off and is no longer available to use. LPA took photos of the Water Drinking Facet "G" in Classroom A.

LPA cleared the above deficiency on this date and provided a copy of issued POC clearance letter during the visit. At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given to Director and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.



Exit interview conducted and report was reviewed with Director Sasha Duarte.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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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