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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400620
Report Date: 03/06/2025
Date Signed: 03/06/2025 11:42:25 AM

Document Has Been Signed on 03/06/2025 11:42 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CII/STANFORD HEAD STARTFACILITY NUMBER:
198400620
ADMINISTRATOR/
DIRECTOR:
JUSTINE LAWRENCEFACILITY TYPE:
850
ADDRESS:706 E. MANCHESTER AVETELEPHONE:
(323) 905-1042
CITY:LOS ANGELESSTATE: CAZIP CODE:
90001
CAPACITY: 48TOTAL ENROLLED CHILDREN: 32CENSUS: 25DATE:
03/06/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Monica OlivoTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analysts (LPAs) T. Tran and L. Voong made an unannounced visit at CII Stanford Head Start to conduct a Case Management Incident occurred on 2/27/2025. The Monterey Park Southwest Office received the writing report on 03/03/2025 regards to food allergy. Upon arrival, LPAs met with site supervisor, Monica Olivo and toured the facility. LPAs observed proper care and supervision and ratio.

LPAs completed files review for child and staff. LPAs obtained child's documents. Interviews conducted with staff and other. On the day of the incident, there were two staff supervised 8 children in care. Per staff after naptime, staff observed C1 waking up with redness and swollen on the right face and arm. Staff immediately took child to the office and contacted child’s parent. Child observed to be breathing normal and conscious. Child was taking to the clinic by parent and pending on the food allergy test result. Based on interviews and record reviewed indicate center staff followed proper protocol when handling this situation, no concerns with the food services or meal plan.

No deficiency was found during today's inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Monica Olivo.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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