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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017158
Report Date: 06/28/2022
Date Signed: 06/28/2022 09:17:32 AM

Document Has Been Signed on 06/28/2022 09:17 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ELLA FITZGERALD CDC/DREW CHILD DEVELOPMENT CORPORAFACILITY NUMBER:
198017158
ADMINISTRATOR:OLA BAILEYFACILITY TYPE:
850
ADDRESS:2590 INDUSTRY WAYTELEPHONE:
(310) 669-9440
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 40TOTAL ENROLLED CHILDREN: 32CENSUS: 16DATE:
06/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Ola Bailey, Site Supervisor TIME COMPLETED:
09:35 AM
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced case management inspection on 06/28/22. LPA arrived at the facility at approximately 8:30AM and met with Ola Bailey, Site Supervisor, who guided LPA on a tour of the facility. There were 16 children present with 3 staff upon arrival.

The purpose of the visit was to follow-up on three incidents that were reported to the department. LPA had previously followed up on two of the three incident on 05/20/22.

LPA conducted interviews and obtained copies of documentation during this visit.

The incident that occurred on 05/10/22, was reported to the Department on 05/10/22, via telephone. The incident that occurred on 05/18/22 was reported to the department on 05/20/22 via telephone. And the incident that occurred on 06/02/22 was reported to the department on 06/02/22 via telephone.

Information reported to the Department indicates that Child #1's, Child #2's, and Child #3's personal rights may have been violated.

Based on the information provided and interviews conducted, there is not enough information to determine whether or not the incidents did or did not occur.

There were no deficiencies cited during today’s inspection. LPA advised Site Supervisor to review regulation 101223 Personal Rights with staff as well as 101226.3 Observation of the Child.

The Notice of Site Visit must remain posted for 30 days. Exit interview was conducted with Ola Bailey, Site Supervisor, including appeal rights and procedures.

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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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