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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191594914
Report Date: 10/12/2022
Date Signed: 10/12/2022 04:44:02 PM


Document Has Been Signed on 10/12/2022 04:44 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:CERRITOS COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191594914
ADMINISTRATOR:DEBRA WARDFACILITY TYPE:
850
ADDRESS:11110 ALONDRA BLVDTELEPHONE:
(562) 860-2451
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:125CENSUS: 62DATE:
10/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Director Debra Ward and Facility Representative Alicia Rosas TIME COMPLETED:
05:00 PM
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Licensing Program Analysts (LPAs) Jeanette Estrada and Austin Estrada conducted an unannounced case management inspection due to an incident that was reported to the Department. LPAs initially met with Director Debra Ward who provided a tour of the facility. There were 62 children and 17 staff present during this inspection.
LPA J. Estrada conducted interviews and obtained documentation during this visit.
The incident occurred on 9/28/22 and was also reported to the Department on 9/28/22 via email. The incident involved Child 1 who sustained an injury that required medical treatment from a medical professional.
Staff 1 stated that on 9/28/22 she took four children to the restroom and Child 1 was flickering the light switch with his right hand. Child 1 was holding the door panel with his left hand and the pointer and middle fingers from the left hand were smashed when another child closed the door behind them. Per Staff 1, she noticed Child 1 was playing with the lights and asked him to stop but did not notice that his left hand was on the side panel. Per Staff 1, Child 1’s two fingers were bruised, Staff 1 applied ice, Child 1’s parent was informed and picked up Child 1. Parent took Child 1 to Urgent Care and it was determined that the tip of the middle finger was broken.
Per Staff 1, they are now waiting for all children to be in the restroom to shut the door and staff are reinforcing to children that adults, teachers and parents, are the only ones that should be opening and closing doors and gates. Child 1 returned to the facility on 10/3/22.
Based on interviews and record review, the staff administered first aid and notified the parent in a timely manner. The facility reported the Unusual Incident to the Department within the required 24 hours of occurrence. LPA determined there will be no deficiencies cited at this time, per California Code of Regulations Title 22, Division 12.

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. Exit interview was conducted with Facility Representative Alicia Rosas.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2022
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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