Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270533
Report Date: 10/25/2018
Date Signed: 10/25/2018 11:06:06 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:BUENA PARK HEAD STARTFACILITY NUMBER:
304270533
ADMINISTRATOR:HEATHER ARNOLDFACILITY TYPE:
850
ADDRESS:6725 DALE STREETTELEPHONE:
(714) 521-1909
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:60CENSUS: 55DATE:
10/25/2018
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Teresa NunezTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Jacqueline Moore met with the Director, Teresa Nunez. LPA toured the facility inside with the Director and census was taken. There was a total of 55 preschool children in three individual classrooms being supervising by 7 staff members. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
LPA met with the Director in regards to an incident that was self reported to the Licensing Office on 9/10/18 by the facility's Director of Center and Program Services. LPA interviewed 3 facility staff members, According to the incident report, the incident occurred on September 6, 2018 a day care parent had informed the facility Director that a day care child had disclosed to the parent that another day care child had hurt and touched the child inappropriately. LPA received copy of child's medical discharge summary.
Due to insufficient information available and further interviews that are needed, the aforementioned allegation needs further investigation.

No deficiencies cited during today's inspection

An exit interview was conducted with the Director. Report was reviewed and discussed. The licensee was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. The first level appeal is to regional manager, address is above on the report. The Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. This report is to be on file and accessible for public review at the facility for at least 3 years.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Jacqueline MooreTELEPHONE: (714) 703-2823
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2018
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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