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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870878
Report Date: 12/02/2021
Date Signed: 12/03/2021 12:28:48 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:
(310) 518-3207
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY:165CENSUS: 61DATE:
12/02/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Principal, Nicola Boykin TIME COMPLETED:
05:30 PM
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On 12/2/2021 Licensing Program Analyst (LPA) Dalicia Adkins conducted an un-announced case management visit to follow up on an Unusual Incident that occurred at the facility. LPA met with Principal Nicola Boykin and was informed about the purpose of the visit. Principal guided LPA on a tour of the facility.

LPA Adkins observed 5 classrooms, age group 3 years to 4 years old. Classroom #1; 2 Teachers EEC Aides and 12 children. Classroom #2; 1 Teacher, 2 EEC Aides and 12 children. Classroom#3: 2 Teachers , 4 EEC Aides and 19 children. Classroom#4: 1 Teacher, 2 EEC Aides and 11 children. Classroom#5; 1 Teacher, 2 EEC Aides and 7 children.

The purpose of today’s visit is to investigate a self reported unusual incident allegation of child being grabbed by staff.

LPA Adkins interviewed staff and children. The following records/supportive documents collected for review: Children’s Roster, Teacher Roster, Earthquake Emergency Drill Certificate of Completion (conducted on 9-20-21 from 10:00 AM 11:15 AM), Staff Statements, Classroom Activity Schedule and Emergency Record.

Based on today's interviews, observations and record review it was determined that the above mentioned allegation requires further investigation.

LPA Adkins reviewed this report with Principal Boykin and exit interview conducted. A notice of site visit provided and required to post for 30 days.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021
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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