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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191502175
Report Date: 09/26/2024
Date Signed: 09/26/2024 01:58:02 PM

Document Has Been Signed on 09/26/2024 01:58 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PLAY FACTORYFACILITY NUMBER:
191502175
ADMINISTRATOR/
DIRECTOR:		LANA SHIFFLETFACILITY TYPE:
850
ADDRESS:9723 GARIBALDI AVE.TELEPHONE:
(626) 285-9223
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY: 74TOTAL ENROLLED CHILDREN: 55CENSUS: 44DATE:
09/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Director, Wendy VeasTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analysts (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to an incident that was reported to the Department on 9/13/2024. LPA met with Director Wendy Veas who guided LPA on a tour of the facility. Census was taken.

On September 13th, 2024, one incident was reported to the Department via Email by the facility who reported a staff alleged that a child's personal rights were violated while in care.



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 five staff and one child. LPA obtained declarations,and statements conducted by the school - Director provided copies of the documents to LPA.

At this time, no deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility Director, Wendy Veas.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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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