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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001331
Report Date: 08/17/2023
Date Signed: 08/17/2023 03:51:08 PM

Document Has Been Signed on 08/17/2023 03:51 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MAOF HEAD START SANTA FE CENTERFACILITY NUMBER:
198001331
ADMINISTRATOR:MARIA HIGAREDAFACILITY TYPE:
850
ADDRESS:6812 SANTA FETELEPHONE:
(323) 581-3923
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY: 36TOTAL ENROLLED CHILDREN: 15CENSUS: 12DATE:
08/17/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Adriana SerranoTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) T. Tran conducted an unannounced Case Management Incident visit at MAOFr Head Start Santa Fe Center to follow up self reported incident occurred on 08/11/2023 regards child's personal rights. The Monterey Park South West Office received the writing report on 08/14/2023. LPA met with Adriana Serrano, EHS designated teacher. LPA observed proper care and supervision.

LPA completed child and staff’s files review. LPA obtained child's document, children's roster, and personnel report. Interviews were conducted with staff and other. On the day of the incident, there were six children present supervised by a fully qualified teacher. Parent was notified of the incident. Based on the available information it does not appear that child's personal rights was violated under Title 22 Regulations.

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, Adriana Serrano.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
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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