191870652-3-1-2024-54-CC-KCHE-D2XQFV-20240301110835

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870652
Report Date: 03/01/2024
Date Signed: 03/01/2024 11:08:40 AM

Document Has Been Signed on 03/01/2024 11:08 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	DOLORES STREET EARLY EDUCATION CENTER		FACILITY NUMBER:	191870652
ADMINISTRATOR:	MIRA HAGOOD		FACILITY TYPE:	850
ADDRESS:	22309 CATSKILL AVE		TELEPHONE:	(310) 830-6987
CITY:	CARSON	STATE: CA	ZIP CODE:	90745
CAPACITY:	116	CENSUS: 76	DATE:	03/01/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Mira Hagood, Facility Representative (FR)		TIME COMPLETED:	11:20 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 03/01/2024 at 9:00 AM Licensing Program Analysts (LPAs) Katrina Chicote and Anthony Padilla conducted an Unannounced Case Management Inspection to follow up on two incidents that were reported to The Department. Upon arrival, LPAs met with Facility Representative (FR), Mira Hagood, Principal, who provided LPAs a tour of the facility inside and outside. Facility is made up of three classrooms: Rm-1, Rm-2, and Rm-3. LPAs observed 42 kids with eight staff in Rm-1 and 34 kids with six staff in Rm-2, totaling 76 preschoolers with 14 staff. On 02/12/2024 an unusual incident report was made to The Department that occurred on 02/09/2024 regarding physical plant issues. It was reported to The Department that Rm-3 had to be closed due to rain damage and that other rooms would be used to accommodate children and staff. LPAs observed Rm-3 and observed area of room to be taped off with caution tape. Per FR, roof has been leaking consistently due to the heavy rains and though there has been many attempts at fixing it the roof has continued to leak. Rm-3 consists of Rm-3A and Rm-3B totaling 45 preschoolers. Per FR, Rm-3A has been temporarily moved to Rm-4, a classroom in the nearby elementary school campus (Dolores Elementary School) and Rm-3B has been split between Rm-1 and Rm-2. LPAs observed Rm-1 and Rm-2 at time of inspection, per FR facility is currently having a special morning program for Black History Month. LPAs observed adequate supervision though rooms are cramped for amount of staff and children. Per FR, Rm-4 is used between 10:15 AM to 2:15 PM which alleviates space issues. Per report submitted, Rm-4 was inspected by LAUSD Representatives prior to it's use though it is not a licensed classroom by CCL. Around 10:15 AM, LPAs walked over to Rm-4 and observed classroom to have adequate supplies and to be free of hazards at time of inspection and a bathroom available with two toilets and two sinks. Per FR, leak has been fixed in Rm-3 and they are currently pending return to use of classroom once OHS comes to check Rm-3 for any hazards and air quality as well as to clean and sanitize room prior to allowing children and staff to return. Per report and record review, Authorized Representatives were provided written notice via letter and on parent communication app, ClassDojo. LPAs discussed supervision and other best practices with FR at time of inspection, FR states that they do use staggered play times and use of indoor classrooms. Report Continues - Page 1 of 2

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DOLORES STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191870652
	VISIT DATE: 03/01/2024

NARRATIVE

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On 02/20/2024 an unusual incident report was made to The Department that occurred on 02/20/2024 regarding a child suffering an injury requiring medical attention. It was reported to The Department that child fell during music and movement time in the morning and hit the back of his head on a book shelf. Authorized Representative was called and child was picked up and taken to the doctor where child received three staples on the back of their head. During this inspection, LPAs observed Rm-2, where incident occurred and did not observe any trip hazards on the floor at time of inspection. Per FR, child returned to facility on 02/28/2024, LPAs observed child at time of inspection and observed child playing and conducting daily activities. Per FR, child's staples have been removed and though child was cleared by doctor to return with limited outdoor play child's Authorized Representative decided to keep child home until staples were removed. LPAs observed child's injury to be healed with no more staples at time of inspection. FR provided documents to LPAs, which were reviewed for child to be medically cleared to return with no restrictions.

Based on LPAs observations, interviews, and record review Licensee reported all incidents within the required 24 hours and submitted written report within seven days. Authorized Representatives for both incidents were also notified within required time frame.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 03/01/2024.

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

Exit interview was conducted and report was reviewed with the Facility Representative, Mira Hagood.

Report Ends - Page 2 of 2

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC809 (FAS) - (06/04)

Page: 2 of 2