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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500168
Report Date: 10/27/2023
Date Signed: 10/27/2023 01:47:32 PM


Document Has Been Signed on 10/27/2023 01:47 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MAGNOLIAFACILITY NUMBER:
191500168
ADMINISTRATOR:CARMEN SANTANAFACILITY TYPE:
850
ADDRESS:11700 PILGRIM WAYTELEPHONE:
(562) 699-1500
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:40CENSUS: 0DATE:
10/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Lead Teacher, Michelle SellsTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced Case Management inspection due to an incident that occurred on 5/24/23 and was reported to the Department on 5/25/23. A COVID risk assessment was conducted. LPA met with Lead Teacher, Michelle Sells to whom the reason for the visit was explained. Ms. Sells guided LPA on a tour of the facility. As the day of the visit was a Staff Development Day, no children were in attendance. Staff #1 and Staff #2 were present in the facility upon arrival. Staff names were recorded. LPA confirmed all individuals present have obtained a criminal record clearance. The licensed facility is within the conditions, limitations, and capacity specified on the license.

On 5/25/23, an unusual incident report was made to the Department regarding an incident on 5/24/23 that involved a child who sustained an injury that required medical attention. Based on information obtained during an interview conducted with the staff that observed the incident, LPA Babcock determined that during outdoor play 2 children were sitting on the ground, when one child got up and accidentally stepped on the hand of another child and the child sustained a fracture to the hand. The injured child was not at the facility on the date of LPA visit, and therefore could not be interviewed. During this inspection, LPA inspected the outdoor area and did not observe any hazards near or on the area where incident took place. Based on interview with staff #1, there was adequate supervision at the time of the incident. It appears that although staff were present, they could not prevent the injury. Child returned to day care with a cast on the hand.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Lilli BabcockTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAGNOLIA
FACILITY NUMBER: 191500168
VISIT DATE: 10/27/2023
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Based on information obtained during this investigation, no additional follow up is necessary regarding the incident reported. The facility followed all proper procedures; child’s parent was notified, incident report was submitted, and all medical needs were met.

No deficiencies are being cited at this time.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Lead Teacher, Michelle Sells.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Lilli BabcockTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC809 (FAS) - (06/04)
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