191602932-3-24-2022-30-CC-DLOE-CCTQDJ-20220324120448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191602932
Report Date: 03/24/2022
Date Signed: 03/24/2022 12:04:56 PM

Document Has Been Signed on 03/24/2022 12:04 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:	DISCOVERYLAND INFANT CARE OF SOUTH BAY JR. ACADEMY		FACILITY NUMBER:	191602932
ADMINISTRATOR:	NILDA BEAUCHAMP		FACILITY TYPE:	830
ADDRESS:	4400 DEL AMO BLVD.		TELEPHONE:	(310) 371-7274
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	36	CENSUS: 10	DATE:	03/24/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Violet Edwards		TIME COMPLETED:	12:15 PM

NARRATIVE

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On 3/24/2022 at 08:57 am, Licensing Program Manager (LPM) Lisa Rios and Licensing Program Analyst (LPA) Deborah Lowe arrived at facility to discuss an amended LIC 809 Facility Evaluation Report for a visit that was conducted on 02/10/2022. LPM Rios and LPA Lowe were greeted by a staff member upon arrival.

At 9:09 am LPM Rios and LPA Lowe toured infant facility and observed 10 Infants under supervision of 6 staff.

Director, Violet Edwards arrived at facility at 9:20 am.

Review of Guardian associations of Criminal Background Clearance shows one staff member with a criminal background clearance that has not completed the background clearance process. Permanent association date to facility was observed as 3/01/2022.

This observation will result in a Type A Citation with a Civil Penalty $500.

LPM and LPA advised this Type A citation will include a civil penalty of $500, $100 for each day the employee was present without a clearance. Allowing any person who is subject to a background check to work, reside or volunteer who does not have either a criminal record clearance or exemption. A civil penalty shall be assessed for a maximum of 5 days for the first violation. For subsequent violations within a 12 month period, a civil penalty shall be assessed for a maximum of 30 days. See California Health and Safety Code Section 1522(c)(1); 1568.09(c); 1569.17(c); and 1596.871(c).

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D)

LPM Rios and LPA Lowe informed licensee Violet Edwards that this report dated 3/24/2022 documents 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
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 03/24/2022 12:04 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: 03/24/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/24/2022 Section Cited	1 2 3 4 5 6 7	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) .... This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based a review of Guardian employee's background clearance was showing "In Process", not cleared to be at facility which poses an immediate health, safety or personal rights risk to persons 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: Claudia Escobedo	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DISCOVERYLAND INFANT CARE OF SOUTH BAY JR. ACADEMY	FACILITY NUMBER: 191602932
	VISIT DATE: 03/24/2022

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Also, LPM Rios and LPA Lowe informed the licensee to provide a copy of this licensing report dated 3/24/2022 that documents any Type A citation 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.

Licensee was provided a copy of their appeal rights.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Violet Edwards.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Deborah Lowe	TELEPHONE: (424) 301-3016
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

LIC809 (FAS) - (06/04)

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