191602046-10-1-2021-54-CC-RNAO-C7DQR8-20211001122330

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191602046
Report Date: 10/01/2021
Date Signed: 10/01/2021 12:23:37 PM

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:	LONG BEACH DAY NURSERY - WEST BRANCH		FACILITY NUMBER:	191602046
ADMINISTRATOR:	LINDA BLACKSHIRE		FACILITY TYPE:	850
ADDRESS:	1548 CHESTNUT AVE		TELEPHONE:	(562) 591-0509
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	95	CENSUS: 27	DATE:	10/01/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	10:36 AM
MET WITH:	Linda Blackshire		TIME COMPLETED:	12:40 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	An unannounced Case Management Inspection was conducted on this day by Licensing Program Analyst (LPA) Raul Navarro to address an Unusual Incident Report that was received in the licensing office on 09/20/21. LPA arrived at the facility at 10:36am and met with Director Linda Blackshire who guided LPA on a tour of facility. On Friday September 20, 2021 Administrative Assistant received two children from parent at the front of the school and walked the children to an empty classroom when the rest of the classroom had already transitioned outside. The two children that were dropped off sat in their assigned seating alone in the classroom (for approximately 25 minutes) before a substitute teacher noticed them and alerted the Director Linda Blackshire. LPA interviewed Administrative Assistant during today's inspection. Per Administrative Assistant, they walked the children to the classroom and dropped them off near the door. Per Administrative Assistant, they announced that the children were being dropped off and thought they heard someone say "okay" and also thought they heard children. Per Administrative Assistant, they later found out the children's classroom had gone out to the playground and the children they heard were from a different classroom. Children were in the classroom by themselves until the substitute teacher observed the children. Based on all information obtained on this date, and interviews conducted with staff, the incident could have been prevented, therefore, a deficiency listed on the following page is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. Deficiencies that are being cited need to be cleared to protect the children’s health & safety Exit interview was conducted with Director Linda Blacksire. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2021

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONG BEACH DAY NURSERY - WEST BRANCH	FACILITY NUMBER: 191602046
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/01/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/08/2021 Section Cited	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a)-The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall
	8 9 10 11 12 13 14	include visual observation. This requirement was not met as evidenced by facility self reporting and interviews conducted. On 9/20/21 two children were left alone in the classroom for approximately 25 minutes. This is a potential risk to the health and safety of the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2021

LIC809 (FAS) - (06/04)

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