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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191592446
Report Date: 10/06/2023
Date Signed: 10/10/2023 01:53:45 PM

Document Has Been Signed on 10/10/2023 01:53 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MAOF CHILD CARE CTR-FLORENCE-BELL GARDENSFACILITY NUMBER:
191592446
ADMINISTRATOR:ERNESTINA HERNANDEZFACILITY TYPE:
850
ADDRESS:6431 EAST FLORENCE AVENUETELEPHONE:
(562) 806-3731
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 8DATE:
10/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ernestina Hernandez, Site SupervisorTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPAs) Alicia Mooberry and Anthony Padilla arrived at the above facility to conduct a Case Management inspection for 2 separate incidents that were reported by the facility on 5/17/23 and 9/21/23 regarding a personal rights concern for a child in care.

Licensing staff conducted file reviews and interviewed child and staff and obtained personnel list and children's roster. Due to insufficient information available at this time, the above incident needs further follow-up.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Ernestina Hernandez.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2023
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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