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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015106
Report Date: 05/23/2024
Date Signed: 05/23/2024 03:31:02 PM

Document Has Been Signed on 05/23/2024 03:31 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:EUCLID HEAD STARTFACILITY NUMBER:
198015106
ADMINISTRATOR/
DIRECTOR:		MARCIE HOUCHENFACILITY TYPE:
850
ADDRESS:817 S. EUCLID AVENUETELEPHONE:
(323) 264-9220
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 30TOTAL ENROLLED CHILDREN: 29CENSUS: 23DATE:
05/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Liliana AguirreTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) T. Tran arrived at the above facility to conduct an unannounced Case Management Incident inspection that was self-reported on 4/17/24. Monterey Park SW Regional Office received the writing incident report on 04/18/24. LPA met with Site Supervisor, Liliana Aguirre and Classroom Specialist Maria Ramirez. LPA observed proper care and supervision. All center staff that was present during today’s inspection had fingerprint cleared and associated to the designated license number.

LPA completed child's record review and obtained some documents and personnel report. Based on the information that was gathered during today's visit, it revealed that on the day of the accident there were three teachers with 14 children. During the interview with staff and others, the incident happened around 12:00PM, C1 was running and tripped hitting the right side of the forehead against the cubby. C1 sustained a small bump. Staff immediately provided first aid and parent was contacted. Per P1 no medical care required and no concerns with the level of care and supervision.
At this time based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.

No deficiency was cited during today’s visit. Notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, Liliana Aguirre.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2024
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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