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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198001533
Report Date: 10/31/2024
Date Signed: 10/31/2024 12:00:42 PM

Document Has Been Signed on 10/31/2024 12:00 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:FREMONT ELEMENTARY HEAD START/STATE PRESCHOOLFACILITY NUMBER:
198001533
ADMINISTRATOR/
DIRECTOR:
MARIANA SANCHEZFACILITY TYPE:
850
ADDRESS:200 W. MADISON AVE.TELEPHONE:
(323) 887-2172
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 0DATE:
10/31/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Dr. Stephanie Hardaway and Vicky BermudezTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced annual continuation visit to the Montebello Unified School District Head Start program located at 8432 Birchbark Ave Pico Rivera, CA 90660 on 10/31/24 at 08:35 am. The purpose of this inspection is to review children and staff as they were not available for review at the Fremont Elementary Head Start/State Preschool facility during the required Annual/Random inspection conducted on 09/18/24. LPA met with Dr. Stephanie Hardaway Director of Head Start and Early Learning and Vicky Bermudez Program Specialist who provided LPA with the children and staff files for review. Also, present was Education Specialist Vanessa Guzman.

Children’s Records were reviewed for completeness: Inspection of required forms was made. LPA issued the Review of Children's Records (LIC 857) to the facility representative during this inspection. The LIC 857 documents the children’s files that were reviewed during this inspection.

Staff’s Records were reviewed for completeness: Inspection of required forms was made. LPA issued the Review of Staff Records (LIC 859) to the facility representative during this inspection. The LIC 859 documents the staff’s files that were reviewed during this inspection. LPA observed Staff 2 (S2) took the mandated reporter training for school personnel instead of the AB 1207.

SB792 (Immunization Requirements for Staff and Employees) was discussed with Dr. Stephanie Hardaway. All staff files reviewed have the required Immunizations.

At this time, the facility is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit Interview was conducted, and a copy of this report was provided to Dr. Stephanie Hardaway.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2024
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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