<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570434
Report Date: 09/24/2024
Date Signed: 09/24/2024 11:54:12 AM

Document Has Been Signed on 09/24/2024 11:54 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SHEPHERD OF THE VALLEY PRESCHOOL & DAY CAREFACILITY NUMBER:
191570434
ADMINISTRATOR/
DIRECTOR:		SOCORRO MAJANOFACILITY TYPE:
850
ADDRESS:1723 PARK LAWNTELEPHONE:
(626) 965-7076
CITY:HACIENDA HEIGHTSSTATE: CAZIP CODE:
91745
CAPACITY: 74TOTAL ENROLLED CHILDREN: 24CENSUS: 22DATE:
09/24/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:10 AM
MET WITH:Brittaney Rivas, DirectorTIME VISIT/
INSPECTION COMPLETED:
12:10 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 09/24/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted. LPA met with Brittaney Rivas, Director and explained the purpose of the visit. There are 22 children with 3 staff members present today.

The purpose of the visit is to follow up on an incident that occurred on 09/12/2024 and an incident report was received on 09/20/2024. The self reported incident is regarding physical environment and supervision.

During today's inspection, LPA toured the area of the incident and interviewed Staff #1 (S1), Staff #2 (S2), Staff #3 (S3) and Child #1 (C1).

LPA toured the area of the incident and did not observe any tripping hazards. Based on observations and interviews with S1, S2, S3 and C1, there were no corroborating information to determine that a physical environment or supervision violation occurred. The facility is not being cited any deficiencies today.

An exit interview was conducted and a copy of this report was provided to the Director.

A Notice of Site Visit was provided; Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2024
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 1