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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021205
Report Date: 06/11/2024
Date Signed: 06/11/2024 03:21:46 PM

Document Has Been Signed on 06/11/2024 03:21 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:HART PRESCHOOLFACILITY NUMBER:
198021205
ADMINISTRATOR/
DIRECTOR:
MONIQUE ORNELASFACILITY TYPE:
850
ADDRESS:859 S. RAYMOND AVE.TELEPHONE:
(213) 422-2176
CITY:PASADENASTATE: CAZIP CODE:
91105
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 24DATE:
06/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Monique Ornelas TIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 06/11/24, at 1:00 pm Licensing Program Analyst (LPA ) Shushanik Safaryan conducted unannounced Case Management Inspection to follow up on an unusual incident report .Upon arrival at 1:00 pm , LPA met with the Facility representatives , Monique Ornelas, and Licensee Emily Laguna ,whom the purpose of the visit was explained . Tour was provided . During the tour LPA observed 24 children with 3 staff members .

On 06/05/24 an incident was reported where a child's personal rights may have been violated . During this inspection LPA conducted interviews with staff , obtained children and staff sign in sheets from the day of the incident .During the visit LPA was unable to interview children . Per Facility Representative Child #1 , Child #2 , Child #3 were absent.

Due to insufficient information available at this time the above incident needs further investigation.



Exit interview conducted with Facility Representative ,Emily Laguna and Appeal Rights explained.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2024
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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