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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191602932
Report Date: 02/10/2022
Date Signed: 03/24/2022 11:23:11 AM


Document Has Been Signed on 03/24/2022 11:23 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 03/23/2022 03:34 PM

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

NARRATIVE
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Licensing Program Analyst (LPA), Deborah Lowe is delivering an amended report of case management deficiency findings by LPA Rios. On February 10th, 2022, Licensing Program Analyst Lisa Rios (LPA Rios) went to the Discoveryland Infant Care of Southbay Jr. Academy to initiate a complaint investigation. During the course of the facility visit, tour, and file review, the following deficiencies were cited: Type A for childcare regulation 1011170 (e)(2)(f)(1).

During the visit, LPA Rios verified that two employees present are not associated to the infant license and cannot have clearances transferred as all associations have been separated for these individuals. Guardian will need to assist with these associations. Per the Director, both employees have been working at the facility since 2021.

Type A citation

LPA Lisa Rios informed Director Violet Edwards that this report dated 2/10/22 is receiving a Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Lisa Rios informed the Director Violet Edwards to provide a copy of this licensing report dated 2/10/22 that documents of any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A copy of this report was given to the Director along with a copy of appeal rights and an exit interview.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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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Document Has Been Signed on 02/10/2022 01:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: DISCOVERYLAND INFANT CARE OF SOUTH BAY JR. ACADEMY
FACILITY NUMBER: 191602932

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/10/2022
Section Cited

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Criminal Record Clearance 101170 (e)(2)(f)(1)(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:(2)Request a transfer of a criminal record clearance as specified in Section 101170(f)(f) A licensee or applicant
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for a license may request a transfer of a criminal record clearance from one state licensed facility to another...
This requirement is not met as evidenced by: Based a review of Guardian a transfer was never requested and can not be conducted today as 2 employees are no longer associated to any previous child care.
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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:
DATE: 02/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/10/2022
LIC809 (FAS) - (06/04)
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