191806026-2-1-2023-33-CC-MGAA-CNMUP3-20230201144453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191806026
Report Date: 02/01/2023
Date Signed: 02/01/2023 02:44:59 PM

Document Has Been Signed on 02/01/2023 02:44 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GREGORY PARK HEAD START/STATE PRE SCHOOL		FACILITY NUMBER:	191806026
ADMINISTRATOR:	MARCIE HOUCHEN		FACILITY TYPE:	850
ADDRESS:	5807 GREGORY AVE.		TELEPHONE:	(323) 463-3061
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90038
CAPACITY:	60	CENSUS: 47	DATE:	02/01/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Sarahi Rodriguez, Head Teacher & Samira Alvarez, Site Supervisor		TIME COMPLETED:	02:50 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	Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced Case Management inspection due to an incidents that were reported to the Department on November 10, 2022 and January 26, 2023. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with Head Teacher, Sarahi Rodriguez who guided LPA on a tour of the facility. Site Supervisor, Samira Alvarez later arrived during this inspection. Census was taken. On November 10, 2022 an unusual incident report was made to the department regarding an incident that involved a child who sustained injury that required medical attention. The facility reported this incident to the Department within the required 24 hours. Based on information obtained during interviews conducted with staff and the parent of child in question, LPA Garcia determined that during outdoor play child#1’s finger was accidentally hit by another’s child’s shoe as child#1 was getting up from slide. Although staff was present and observed the incident, staff could not reach the child in time to prevent injury. At 11:40 a.m., during this inspection LPA did not observe any hazards near or on the area where incident took place. Child was taken to the doctor and no medical treatment/restrictions were given. Child has returned to day care. REPORT CONTINUES ON NEXT PAGE 1 OF 2.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GREGORY PARK HEAD START/STATE PRE SCHOOL	FACILITY NUMBER: 191806026
	VISIT DATE: 02/01/2023

NARRATIVE

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On January 26, 2023 an unusual incident report was made to the department regarding an incident that involved a child who sustained injury that required medical attention. The facility reported this incident to the Department within the required 24 hours.

Based on information obtained during interviews conducted with staff and the parent of child in question, LPA Garcia determined that during indoor classroom time child #2 was pushed by another child and child #2 fell and bumped head against the corner toy shelf. Although staff was present and observed the incident, staff could not reach the child in time to prevent injury. At 9:20 a.m., during this inspection LPA did not observe any tripping hazards near or on the area where incident took place. Child was taken to the doctor and no medical treatment/restrictions were given. Child has returned to day care.

Based on information obtained during this investigation, no follow up is necessary regarding the incidents reported on 11/10/22 and 1/26/23. The facility followed all proper procedures; Staff administered first aid, children’s parents were notified, incident reports were sent in properly and timely and all medical needs were met. Per Site Supervisor, staff reminded children about classroom rules; no pushing, hitting and reminders about using gentle hands and rules on how to use outdoor slide to prevent accidents in the future.

A notice of site visit was given and must remain posted for 30 days.

At this time, there were no deficiencies cited during today’s inspection.

Exit interview conducted and report was reviewed with the facility representative, Samira Alvarez.

END OF REPORT: PAGE 2 OF 2.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2