<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191571456
Report Date: 11/13/2024
Date Signed: 11/13/2024 02:52:51 PM

Document Has Been Signed on 11/13/2024 02:52 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:YMCA SUNSHINE P/S STARBUCK SITEFACILITY NUMBER:
191571456
ADMINISTRATOR/
DIRECTOR:
SUSETTE SEPULVEDAFACILITY TYPE:
850
ADDRESS:15740 E STARBUCK STREETTELEPHONE:
(562) 943-7241
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY: 104TOTAL ENROLLED CHILDREN: 16CENSUS: 11DATE:
11/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:Director, Adriana AllenTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced Case Management inspection due to an incident that occurred at the facility on 10/15/24. LPA met with Lead Teacher, Linda Pena to whom the reason for the visit was explained. Ms. Pena guided LPA on a tour of the facility. Census was taken. There were two staff present caring for eleven children. The facility was observed to be operating within the license capacity limitations. Director, Adriana Allen arrived at the facility at approximately 2:00 pm.

On October 15, 2024, an unusual incident report was made to the Department regarding an incident that involved a child who sustained an injury at the facility which required medical attention. During the visit, LPA Babcock conducted interviews with two staff, and Child #1 (C1). Based on information obtained during interviews conducted with staff, LPA Babcock determined that on October 15, 2024 while walking from the classroom to the library, C1 was walking down the 4 steps located outside the door of Classroom #2, while holding another child's hand. The other child stumbled but regained their footing and C1 stumbled but could not regain balance and fell, hitting their chin on the concrete below the four steps. C1 sustained a cut on their chin. Staff administered first aid by placing paper towels and an icepack under the chin of C1. Based on interviews with staff, the facility was in ratio at the time of the incident. Parent of C1 was promptly notified of the incident. C1 was taken by parent for medical treatment and the wound was glued by medical personnel. Per Director, C1 returned to the facility the following day.

During the visit, LPA obtained a copy of the injury report given to parent of Child #1.

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 Director, Adriana Allen.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1