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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000225
Report Date: 07/18/2024
Date Signed: 07/18/2024 04:25:17 PM

Document Has Been Signed on 07/18/2024 04:25 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BASSETT HEAD START/ERWINFACILITY NUMBER:
198000225
ADMINISTRATOR/
DIRECTOR:
R. DUCOING/Y. OROZCOFACILITY TYPE:
850
ADDRESS:943 N. SUNKIST AVENUETELEPHONE:
(626) 931-3161
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 168TOTAL ENROLLED CHILDREN: 168CENSUS: 40DATE:
07/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Mercedes Gomez & Rosie DucoingTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On July 18, 2024, at 1:30 pm Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an incident that was self-reported and submitted by the facility that occurred on 5/14/2024. Covid risk assessment was conducted. LPA met with Child Development Supervisor, Mercedes Gomez. Child Development Program Director, Rosie Ducoing joined the visit approximately at 3:30pm to facilitate visit. LPA observed and took a census of 40 children with 9 staff.

The incident was reported to the Department within the required 24 hours of occurrence. The incident was due to a parent concern about their child. The facility conducted their own investigation and have not concluded their findings. Child Development Supervisor has sent via email only 1 staff statement and is waiting for additional statements. According to Child Development Supervisor, Parent has not submitted a written statement as requested. Children’s roster has been sent to LPA via email.

During this investigation, LPA conducted interviews with Child #1 (C1), #2 (C2), and #3 (C3). LPA was unable to interview staff during this visit, but Child Development Supervisor has provided contact staff information. During the visit LPA conducted consultation with Child Development Program Director.

No citations have been issued 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 Child Development Program Director, Rosie Ducoing.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
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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