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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870878
Report Date: 11/25/2019
Date Signed: 11/25/2019 05:13:35 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:WILMINTON PARK EARLY EDUCATION CENTERFACILITY NUMBER:
191870878
ADMINISTRATOR:UDEOCHU, MERCYFACILITY TYPE:
850
ADDRESS:1419 YOUNG ST.TELEPHONE:
3105183207
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY:165CENSUS: 78DATE:
11/25/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Nicola Boyken, Director Assistant TIME COMPLETED:
04:58 PM
NARRATIVE
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On 11/25/2019 at 2:30pm, Licensing Program Analyst (LPA) Denise Miranda arrived at Wilmington Early Educational Center for the purpose of following up on the unusual incident that occurred at the facility on 10/21/2019. LPA met with Ms. Boyken, Director Assistant and discussed the purpose of the visit.

According to the report that the Department received, the incident occurred on 10/21/2019 at 4:25pm, during picked time, the mother of the child#1 observed child#1 by herself inside of the classroom#2, playing with toys unsupervised.

Based on the information obtained during the interviews, there were 5 staff supervising 26 children at the time of the incident; ratios were within compliance. LPA also obtained a copy of the sign in and sign out sheet dated 1021/2019. Based on the information gathered throughout the course of the investigation, it does appear that the incident was a result of a lack of care and supervision.No staff observed when child#1 went inside of the classroom#2 and was playing without care and supervision. Facility was cited a Type A violation today, 11/25/2019 (See LIC 809-D for deficiency cited.)

The following was discussed with licensee: AB 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility. An exit interview was conducted and a copy of this report, appeal rights along with the Notice of Site Visit were provided to Ms. Nicola Boyen, Director Assistant.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: WILMINTON PARK EARLY EDUCATION CENTER
FACILITY NUMBER: 191870878
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/25/2019
Section Cited

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101229 Responsibility for Providing Care and Supervision. (a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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This requirement is not met as evidenced by: On 10/21/2019 aroun 4:25pm, during the picked time, mother of the child#1 observed her child wihtout supervision inside of the classroom#2. This is a Type A citation and poses an immediatelyl health and safety risk to children in care.
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of this report and a form LIC9224 Acknowledgement of Receipt of LIcensing Report. Facility will maintained a copy of the form LIC9224 inside of child's record signed by children's parents/guardian.

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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: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:
DATE: 11/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/25/2019
LIC809 (FAS) - (06/04)
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