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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806267
Report Date: 05/15/2024
Date Signed: 05/15/2024 08:52:39 AM

Document Has Been Signed on 05/15/2024 08:52 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:NHA - ALTADENA HEAD STARTFACILITY NUMBER:
370806267
ADMINISTRATOR/
DIRECTOR:		LAURA PHILLIPSFACILITY TYPE:
850
ADDRESS:3770 ALTADENA AVENUETELEPHONE:
(619) 280-6951
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 43TOTAL ENROLLED CHILDREN: 43CENSUS: 10DATE:
05/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Laura PhillipsTIME VISIT/
INSPECTION COMPLETED:
08:30 AM
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On May 15th, 2024, at 7:30 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management inspection to follow-up on an incident that occurred on 05/07/2024. LPA advised Staff Yanitza Patino of the meeting’s purpose and was granted facility entry. Staff Patino provided LPA with a facility tour.

A child experienced a changed condition during nap time on 05/07/2024. The child was transported via ambulance to the hospital on 05/07/2024. They returned to care on 05/09/2024. The incident was self reported by the facility. There were 15 children with 1 staff during the incident. On 05/07/2024, at about 1 PM, the child woke from nap time. They sat up and staff observed the child's changed condition. Staff contacted the parent and paramedics. Paramedics transported the child to the hospital. LPA inspected the classroom and observed that the equipment and furniture is age appropriate. There were no apparent hazards accessible to children. The parent expressed no concerns or complaints about the facility. No deficiencies cited.



A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Licensee/Appeal Rights (LIC 9058) was provided to Director Laura Phillips. Exit interview conducted and report was reviewed with the facility representative Director Laura Phillips.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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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