198601468-3-21-2025-11-AS-SLEO-DEYTTQ-20250321150108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198601468
Report Date: 03/21/2025
Date Signed: 03/21/2025 03:01:17 PM

Document Has Been Signed on 03/21/2025 03:01 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
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	MYCHAL'S LEARNING PLACE		FACILITY NUMBER:	198601468
ADMINISTRATOR/ DIRECTOR:	EDWARD LYNCH		FACILITY TYPE:	775
ADDRESS:	4901 W. ROSECRANS AVE		TELEPHONE:	(310) 297-9333
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY: 45		CENSUS: 37	DATE:	03/21/2025
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:00 AM
MET WITH:	Interim Administrator - Bridgett Franco		TIME VISIT/ INSPECTION COMPLETED:	03:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 03/22/2025 around 8:00 AM, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) Licensing Program Analyst (LPA) Socorro Leandro and LPA Jose Anguiano conducted continuation unannounced Required – 1 Year Inspection to the above-named facility and met with the Interim Administrator, Bridgett Franco and was granted entrance into the facility. LPA explained the purpose of the visit and was accompanied by the Interim Administrator inside and outside the facility during this inspection. Facility Layout: The facility is a one-story industrial building located on a main street. The building consist of: 1 entrance lobby; 1 conference room; 6 offices (this includes the new office that the facility recently created); 1 computer room; 1 large conference room/classroom; 1 laundry room; 2 music rooms; 1 client break room (has a bed, desk, chair, and bed linens); 3 kitchen rooms which consist of: 1 large industrial kitchen, 1 kitchen room that is dedicated for baking, 1 kitchen room that is dedicated for the dining area; 1 food pantry room; 1 gym equipment area; 1 storage room dedicated for tools; 1 large activity room; 1 art room; 1 outside patio area; 4 restrooms; rest area room; electrical/storage room.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2025

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 4

Document Has Been Signed on 04/22/2025 11:53 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 04/14/2025 01:47 PM

Created By: Socorro Leandro On 03/21/2025 at 01:55 PM

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
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MYCHAL'S LEARNING PLACE	FACILITY NUMBER: 198601468
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82086(a-b)

Alterations to Existing Buildings or New Facilities (a) Prior to construction or alterations, all licensees shall notify the licensing agency of the proposed change. (b) The licensing agency shall have the authority to require that the licensee have a building inspection by a local building inspector if the agency suspects that a hazard to the clients' health and safety exists. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in creating 2 new kitchen rooms and a new office room without informing the department of the building alterations which posesa potential health, safety to persons in care.
	POC Due Date: 06/25/2025
	Plan of Correction
1 2 3 4	The Interim Adminsitrator agreed to agreed to have a city inspector inspect the building, get the building approved through the city, update the facility sketch, and submit documentation to Socorro.Leandro@dss.ca.gov .

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Ulysses Coronel

LICENSING EVALUATOR NAME:

Socorro Leandro

LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MYCHAL'S LEARNING PLACE	FACILITY NUMBER: 198601468
	VISIT DATE: 03/21/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Facility Sketch: The department reviewed the facility sketch and the facility layout is not the same as the facility sketch. The facility sketch has 1 kitchen room and 5 office rooms.

Outside Grounds: were toured no bodies of water were observed, walkways around the building were clear of hazards, and there are no security bars or weapons on the premises.

Kitchen Area: Knives and toxins were kept inaccessible to clients in care. There is fire extinguisher in the kitchen area, and it was last serviced on 12/24/2024. There is a landline telephone on the kitchen counter.

Bathrooms: Toilets and water faucets worked properly, grab bars were secure. Adequate lighting and toiletries accessible to clients.

Miscellaneous: Documents are posted as mandated. There are landline telephones in each office except for the office that is currently going through construction. There are videoconferencing devices in the facility. There are games, books, art supplies, musical instruments, etc. for clients to use. The last fire and earthquake drill was conducted on 3/7/2025. There are fire extinguishers around the building and they were last serviced on 12/24/2024.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MYCHAL'S LEARNING PLACE	FACILITY NUMBER: 198601468
	VISIT DATE: 03/21/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

5 staff records were reviewed, 5 out of 5 staff records had required documentation.

5 client records were reviewed and, 5 out of 5 client records had required documentation.

A technical advisor is being provided regarding updating the Emergency Disaster Plan, Infection Control Plan, and maintaining records in the facility.

A technical violation is being provided regarding the facility not having an Administrator. The department had a conversation with the Interim Administrator about the importance an Administrator.

A deficiency is being cited based on observations, interviews, and records reviewed regarding California Code of Regulations, Title 22, Division 6, Chapter 3, Article 7. Physical Environment, 82086 (a-b) Alterations to Existing Building or New Facilities, see LIC809D. A violation regarding alterations to facility building.

An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Interim Administrator.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2025

LIC809 (FAS) - (06/04)

Page: 4 of 4