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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191591710
Report Date: 11/21/2024
Date Signed: 11/25/2024 01:07:40 PM

Document Has Been Signed on 11/25/2024 01:07 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:PACIFIC FRIENDS SCHOOLFACILITY NUMBER:
191591710
ADMINISTRATOR/
DIRECTOR:		LAURENE HERRERAFACILITY TYPE:
850
ADDRESS:6210 TEMPLE CITY BLVDTELEPHONE:
(626) 287-6880
CITY:TEMPLE CITYSTATE: CAZIP CODE:
91780
CAPACITY: 58TOTAL ENROLLED CHILDREN: 58CENSUS: 25DATE:
11/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Veronica Palomera TIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Director Veronica Palomera.

The purpose of this inspection was to obtain additional information regarding an unusual incident report provided by the facility on 11/13/2024.

During the course of this inspection LPA Lee conducted interviews and made observations in regards to the incident that occurred at the facility on 11/12/2024.

Based on the information obtained, LPA Lee did not observe any deficiencies at this time.

The notice of site inspection must remain posted for a period 30 days during hours of operation Failure to maintain posting during business hours will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Director Veronica Palomera. Appeal rights discussed and explained.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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