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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870909
Report Date: 11/19/2019
Date Signed: 11/19/2019 12:17:06 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:WESTMINSTER AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870909
ADMINISTRATOR:SCRUGGS, LIZAFACILITY TYPE:
850
ADDRESS:1010 MAIN ST.TELEPHONE:
3103924581
CITY:VENICESTATE: CAZIP CODE:
90291
CAPACITY:117CENSUS: 65DATE:
11/19/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:56 AM
MET WITH:Ricky Lim, PrincipalTIME COMPLETED:
12:15 PM
NARRATIVE
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On 11/19/2019 at 10:56am, Licensing Program Analyst (LPA) Denise Miranda arrived at Westminster Early Education Center for the purpose of delivering the investigation findings on the unusual incident that occurred at the facility on 6/25/2019. LPA met with Ricky Lim, Principal, and discussed the purpose of the visit. There was a total census of 65 children in care with 13 staff.
According to the unusual incident/injury report (UIR) that the Department received, on 6/25/2019, Staff#2 and #3 observed child#1 outside of the classroom on his cot. Child#1 stated that staff#1 placed him outside of the classroom.
Based on the information that were gathered through investigation, LPA's observations of the facility, interviews and review of document, it was revealed that on 6/25/2019 at approximately 2:00 pm, staff#1 placed outside of the classroom child #1 on his cot while the other children were sleeping inside of the classroom. It appears that the incident was the result of a Title 22 violation for personal rights. Facility was cited a Type A violation today, 11/19/19. (See LIC 809-D for deficiency cited).
The following was discussed with licensee:
AB 633 was discussed:
This bill requires that, upon receipt, a licensed child care facility shall provide to the parents or guardians of each child receiving services in the facility:
I. Copies of any licensing report that documents any Type A citation. This includes facility visits and substantiated complaint investigations.
II. Any licensing documents pertaining to a conference conducted by a local licensing agency management
representative with the licensee in which issues of noncompliance are discussed.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
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: WESTMINSTER AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870909
VISIT DATE: 11/19/2019
NARRATIVE
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III. Copies of a summary of an accusation indicating the Department’s intent to revoke the license, until that accusation is either dismissed or resolved through the administrative hearing process or stipulated agreement.
IV. Copies of any of the above licensing documents that the licensee has received in the prior 12-month period shall be provided to the parents of newly enrolling child, upon enrollment.

LPA provided copy of the form LIC 9224 Acknowledgement of Receipt of Licensing Reports. Facility shall maintain a copy of this document (LIC 9224 Acknowledgement of Receipt of Licensing Reports) signed from parents/guardian in children’s file and a copy to provide to children's parents.
LPA, also provided copy of the title 22 - 101223 - Personal Rights.

An exit interview was conducted and a copy of this report, appeal rights along with the Notice of Site Visit were provided to Ricky Lim, Principal. Also, The Department will mail a copy of this report to facility’s mailing address. A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
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: WESTMINSTER AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870909
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/19/2019
Section Cited

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Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. (3) To be free from corporal or
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unusual punishment, infliction of pain, humiliation, intimidation This requirement is not met as evidenced by: 6/25/2019, staff#1 placed outside of the classroom child #1 on his cot while the other children were sleeping inside of the classroom. This is a type A violation and it poses an immediate risk to the H&S of children in care
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LPA obtained copies of plan of correction that school made regarding this incident. Staff#1 shall ceased this type of violation of child’s personal rights immediately. During this visit LPA clear the plan of correction and copy was provided to Principal Ricky Lim

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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: 11/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2019
LIC809 (FAS) - (06/04)
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