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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191595830
Report Date: 01/04/2022
Date Signed: 01/04/2022 10:02:06 AM

Document Has Been Signed on 01/04/2022 10:02 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:FOSTER ROAD STATE PRESCHOOLFACILITY NUMBER:
191595830
ADMINISTRATOR:YANETH GARCIAFACILITY TYPE:
850
ADDRESS:13930 E. FOSTER RD.TELEPHONE:
(562) 921-9908
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 8DATE:
01/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Laurel Parker, Program DirectorTIME COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Mila Quinto conducted a case management inspection in response to a self-reported incident on December 14, 2021. LPA met with Maria Salazar-Gallo and Laurel Parker. Census was taken and the overall census observed were 4 staff and 22 preschool children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

LPA interviewed 2 staff members during the visit. LPA also obtained a current children’s roster.

Due to insufficient information available at this time, the above incident needs further investigation. An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15). All appeals must be in writing and received by the Licensing office within 15 business days.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 01/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/04/2022
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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