191870566-10-26-2023-33-CC-MJAA-CWYNV9-20231026104734

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870566
Report Date: 10/26/2023
Date Signed: 10/26/2023 10:47:39 AM

Document Has Been Signed on 10/26/2023 10:47 AM - 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:	CENTRO DE NINOS, MARAVILLA		FACILITY NUMBER:	191870566
ADMINISTRATOR:	LETICIA SANTOS CUEVAS		FACILITY TYPE:	850
ADDRESS:	4850 E. CESAR CHAVEZ AVENUE		TELEPHONE:	(323) 268-4600
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90022
CAPACITY:	68	CENSUS: 48	DATE:	10/26/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Leticia Cuevas, Director		TIME COMPLETED:	10:50 AM

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	On October 26, 2023, Licensing Program Analysts (LPAs) Monique Ayala and Kruz Long conducted an unannounced Case Management inspection for two incidents that occurred on 10/11/2023 and was reported to the department on 10/13/2023. LPAs met with director, Leticia Cuevas who guided LPAs on a tour of the facility. LPAs observed 48 children in care. Brief summary: On 10/11/2023 10:20am, C1 got on top of a seat and fell over. C1 hit her lip and C2's lips became swollen. On the same date at at 4:35pm, Child #2 (C2) was at a table drawing when she fell sideways from her chair hitting the side of her forehead. C2 sustained a bruise from the incident. During this inspection LPAs interviewed Staff #1 (S1) to Staff #3 (S3), LPAs reviewed C1 and C2's file and reviewed S1 and S2 file. Based on interviews with S1 and S3, the incident with C1 occurred outside in the play area near the play house and quiet area. S1 stated that she as about 6 feet away from C1 when the incident occurred. S1 stated that C2 placed her foot on the side of the chair attempting to climb the chair. S1 stated that as she was attempting to redirect C1; however the weight of C1 flipped the chair causing the chair to hit C1 on the lip. S1 stated she saw the incident happen and saw blood coming from C1's mouth. S1 placed gloves on and asked S2 to take C1 to the office where S3 applied ice and notified C1 parents. LPAs observed the chair to be age appropriate for children. During the time of the incident there were 18 children with 5 staff. Based on interviews S2 and S3, the incident with C2 occurred in the classroom at a table during activity time. S2 stated that C2 was doing an activity at the table and lost her balance causing her to fall off of the chair hitting her head on the floor. C2 sustained a bump and a bruise. Per S2, C2 was sitting correctly. S3 stated that an ice pack was applied and parent was notified through learning genie and an incident report was provided to parent. LPAs observed the chair to be age appropriate. During the time of the incident there were 8 children with 3 staff.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CENTRO DE NINOS, MARAVILLA	FACILITY NUMBER: 191870566
	VISIT DATE: 10/26/2023

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The facility was found to be in ratio compliance for both incidents. The incident occurred fast where staff were unable to prevent the incidents from happening. Parents were notified in a timely manner. The facility is not being cited any deficiencies today, 10/26/2023.

An exit interview was conducted and a copy of this report was provided to director along with Notice of Site Visit. Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023

LIC809 (FAS) - (06/04)

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