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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198002482
Report Date: 11/16/2023
Date Signed: 11/16/2023 04:03:41 PM

Document Has Been Signed on 11/16/2023 04:03 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MAOF HEAD START ZOE AVENUE CENTERFACILITY NUMBER:
198002482
ADMINISTRATOR:CYNTHIA RODRIGUEZFACILITY TYPE:
850
ADDRESS:2650 ZOE AVE.TELEPHONE:
(323) 584-5828
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY: 85TOTAL ENROLLED CHILDREN: 85CENSUS: DATE:
11/16/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Araceli GarciaTIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst, (LPA) T. Tran made an unannounced case management- incident visit at the above licensed facility to follow up on a self-reported incident. Between 10/29/23-11/3/23, facility had confirmed with 18 cases of gastrointestinal outbreak. Upon arrival, LPA met with head teacher, Araceli Garcia and toured the center inside and outside.

LPA completed children's file reviews and obtained children's document, children's roster, and LIC500-personnel report. During the outbreak, facility had reported to the health department and all enrolled families were notified. Per staff, on November 6, 2023, health department had visited the site and no indication of concern at the site. Facility had posted the outbreak exposure letter by the entrance. The maintenance team had conducted the deep cleaning twice at the facility. Staff were given specific instructions to sanitize the indoor and outdoor space daily, all toys, materials, tables, chairs, floors, stuff animals, and napping sheets were disinfected and washed. None of the children involved were hospitalized. All children had been cleared and returned to school.

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, Araceli Garcia.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
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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