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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006555
Report Date: 01/08/2024
Date Signed: 01/08/2024 03:03:02 PM

Document Has Been Signed on 01/08/2024 03:03 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HILLCREST HEAD START/GARVEY SCHOOL DISTRICTFACILITY NUMBER:
198006555
ADMINISTRATOR:ROBIN LIBBYFACILITY TYPE:
850
ADDRESS:795 PEPPER STREETTELEPHONE:
(626) 927-5891
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91755
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 26DATE:
01/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Program Manager, Patricia Yaghman TIME COMPLETED:
03:15 PM
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On 01/08/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. A COVID-19 risk assessment was conducted. LPA met with Program Manager, Patricia Yaghman who guided LPA on a tour of the outdoor play yard. There are 11 children in room #1 with 2 staff and 15 children in room #2 with 2 Staff.

The purpose of the visit is to follow up on an incident that occurred on 12/07/23 and was reported to the department on 12/07/23 (reported timely). The self reported incident is regarding personal rights.

During this visit, LPA interviewed Staff #1 (S1) to Staff #3 and Child #1 (C1) to Child #3.

LPA observed the outside play structure to be in good repair and did not pose a safety hazard to the children. Per interviews with Staff, the facility was in ratio and had sufficient supervision during the time of the incident. Interviews with Children indicate there is supervision and they felt safe playing on the play structure. After the incident, medical assistance was applied and proper procedures were followed.

Based on LPA's interviews and observations, there is no violation of Title 22 regulations. Therefore, no deficiencies are being cited during today's visit.

An exit interview was conducted and a copy of this report was provided to Program Manager, Patricia Yaghman. A Notice of Site Visit was provided; Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2024
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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