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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870748
Report Date: 11/02/2021
Date Signed: 11/02/2021 01:27:38 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
FACILITY NAME:HYDE PARK EARLY EDUCATION CENTERFACILITY NUMBER:
191870748
ADMINISTRATOR:COLLINS, CAROLFACILITY TYPE:
850
ADDRESS:6428 11TH AVE.TELEPHONE:
(323) 751-4147
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY:77CENSUS: 19DATE:
11/02/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Allison Speight, PrincipalTIME COMPLETED:
01:45 PM
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On 11/02/2021, Licensing Program Analyst (LPA) Lisa Clayton, conducted a case management inspection to follow up on an Unusual Incident reported to the department by telephone on 10/19/2021. LPA met with Allison Speight, Principal and toured the facility and took a census of the children. Upon arrival, there were 19 children and 20 staff present today at the facility.

Description of the incident: On 10/19/2021 at approximately 10:35am, C1 was playing on the Fire Truck play structure outside and while climbing on the “tire/ladder section” she slipped and fell forward hitting her left cheek. Teacher Akida Crosby witnessed the incident and immediately helped C1 up, took her inside and applied an ice pack to her face. Principal Allison Speight was notified and began calling C1’s mom. 3 attempts were made to reach Mom (at 10:45am, 11:00am, and 11:32am). At 11:32am mom was reached, and informed of the incident. Mom acknowledged understanding and said she would see her face and the injury when she picked C1 up. Mom also provided a better phone number to reach her in case of emergency. LPA Clayton interviewed C1 who verified that she fell on the tire ladder and that Ms. Akida helped her and made her feel better when she hurt herself.

Based on the information obtained, interviews conducted and LPA's observation, care and 100% supervision was being provided when C1 fell and the incident was an accident; therefore, no Title 22 violations have occurred and no deficiencies cited. Principal was encouraged to continue to report unusual incidents that occur in the facility in a timely manner.

An exit interview was conducted, a copy of this report and notice of site visit was provided to Principal Allison Speight.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
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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