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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600232
Report Date: 05/07/2024
Date Signed: 05/07/2024 02:36:25 PM


Document Has Been Signed on 05/07/2024 02:36 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:FIRST UNITED METHODIST CHURCH PRESCHOOLFACILITY NUMBER:
191600232
ADMINISTRATOR:BATSHEVA SPECTORFACILITY TYPE:
850
ADDRESS:1008 11TH STREETTELEPHONE:
(310) 395-7292
CITY:SANTA MONICASTATE: CAZIP CODE:
90403
CAPACITY:128CENSUS: 79DATE:
05/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Dee Menzies, DirectorTIME COMPLETED:
02:00 PM
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On 05/07/2024, Licensing Program Analyst, Judy Laureano conducted an unannounced case management inspection at the above mentioned facility. LPA met with Dane Rold (Assistant Director) and Dee Menzies (director), who guided LPA on a tour of the facility both indoors and outdoors.

LPA observed 79 children and 12 staff members providing care and supervision. LPA observed children in their classroom finishing up. Classrooms were observed getting ready for nap time; sleeping cots set out.

Facility contacted the On Duty worker on 3/20/2024 to report an unusual incident that occurred at the facility on 3/19/2024. Unusual incident report submitted to the El Segundo Child Care Regional Office states that children were playing outside on the yard with modular foam blocks. Child named on the incident report (C1) fell over on his arm. C1 was observed holding his arm and whimpering, staff closest to him attended to C1. Child was providing with an ice pack and parents were notified immediately. Child was taken to hospital and x-ray showed dislocated elbow and broken arm.


The day of the incident, director confirmed that 5 staff members were outside in the yard providing care and supervision.

During today’s inspection, LPA observed the outdoor space, the equipment that children were using during the incident and the placement of each teacher in the yard. LPA interviewed staff named in the incident report and interviewed child.

There were no citations issued during today’s inspection. The Unusual Incident Report investigation will continue.

An exit interview was conducted. A copy of this report (LIC 809) and Notice of Site Visit was provided to facility director Dee Menzies.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:
DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/07/2024
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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