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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021419
Report Date: 12/03/2024
Date Signed: 12/03/2024 11:23:22 AM

Document Has Been Signed on 12/03/2024 11:23 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:LINCOLN HEIGHTS HEAD STARTFACILITY NUMBER:
198021419
ADMINISTRATOR/
DIRECTOR:		HOUCHEN, MARCIEFACILITY TYPE:
860
ADDRESS:2141 WORKMAN STTELEPHONE:
(626) 572-5107
CITY:LOS ANGELESSTATE: CAZIP CODE:
90031
CAPACITY: 30TOTAL ENROLLED CHILDREN: 17CENSUS: 16DATE:
12/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Norma Juarez, Child Development SpecialistTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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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 11/14/2024. LPA met with Head Teacher who guided LPA on a tour of the facility. Census was taken. At 9:50 a.m., Child Development Specialist, Norma Juarez arrived to the facility.

On November 14th, 2024, one incident was self-reported to the Department via Phone by the facility who reported a child sustained an injury that required medical treatment.



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 staff and Child #1. Regarding the incident on 11/14/2024, Staff #2 observed Child #1 running outdoors when they saw Child #1 run into the easel located in the middle of the outdoor play area. Staff #1 and Staff #2 observed a cut on Child #1 right eyebrow. Per Staff #1, first aid was administered, Staff #1 called paramedics and parents were notified. Paramedics released Child #1 to grandparents and Child #1 was taken to their primary physician- Child #1 received one stitch. Child #1 has been cleared to return to school with no restriction.

LPA asked for copies of incident report, and school excuse form from the doctor's office.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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 2
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: LINCOLN HEIGHTS HEAD START
FACILITY NUMBER: 198021419
VISIT DATE: 12/03/2024
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A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Norma Juarez.

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

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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