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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020154
Report Date: 06/02/2022
Date Signed: 06/02/2022 04:11:10 PM

Document Has Been Signed on 06/02/2022 04:11 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CESAR CHAVEZ ELEMENTARY HEAD STARTFACILITY NUMBER:
198020154
ADMINISTRATOR:MARIANA SANCHEZFACILITY TYPE:
850
ADDRESS:6139 LOVELAND AVETELEPHONE:
(323) 773-1804
CITY:BELL GARDENSSTATE: CAZIP CODE:
90201
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 57DATE:
06/02/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Veronica Herrera, TeacherTIME COMPLETED:
04:35 PM
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Licensing Program Analyst (LPA) T. Tran arrived at Cesar Chavez Head Start to conduct an unannounced Case Management inspection that was self-reported on 5/19/2022 regarding a concerned parent stated staff grabbed C1 by the neck. The Monterey Park South West Child Care Regional Office received the incident report on 5/23/2022. LPA met with teacher Veronica Herrera and we toured the facility. LPA observed proper care and supervision.

LPA completed files review for staff, children. LPA obtained child's record and LIC 500. Based on the available information that were gathered through interviews with staff and other. On the day of the incident, there were two staff supervised 12 children. According to the available information, it does not appear this incident was the result of a Title 22 violation for Personal Rights.

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, Veronica Herrera.




SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2022
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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