191871812-7-13-2023-54-CC-RNAO-CTPN85-20230713101347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191871812
Report Date: 07/13/2023
Date Signed: 07/13/2023 10:13:51 AM

Document Has Been Signed on 07/13/2023 10:13 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHILDTIME CHILDREN'S CENTER		FACILITY NUMBER:	191871812
ADMINISTRATOR:	ANA FRAGOSO-TOVALIN		FACILITY TYPE:	850
ADDRESS:	4820 S. EASTERN AVENUE #F		TELEPHONE:	(323) 721-0552
CITY:	COMMERCE	STATE: CA	ZIP CODE:	90040
CAPACITY:	72	CENSUS: 24	DATE:	07/13/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Ana Fragoso-Director		TIME COMPLETED:	10:34 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	An unannounced Case Management Inspection was conducted on this day by Licensing Program Analyst (LPA) Raul Navarro in regards to an Unusual Incident Report that was received in the licensing office on 06/27/23. LPA arrived at the facility at 8:45am and met with Director Ana Fragoso who guided LPA on a tour of facility. On 06/26/23, at approximately 10:00am, Child #1 was playing outside in the playground when he fell and quickly got up and continued playing. After nap time he was walking on his tipi toes and teacher checked him. Child started to cry asking for mom. Child's mom took child to urgent care. Child was diagnosed with a sprain. Child's parent reported to the facility that child will be out for about two weeks. LPA interviewed the Director Ana Fragaso. Per Director, the Child#1 was taken to urgent care by parent as a precautionary measure. Child #1 was diagnosed with a sprain but returned to the facility the following week. Child's parent took child to get x-rays which came back negative and there was no fracture. LPA Navarro observe the child at the facility. Child was observed to be running and playing in the playground. LPA interviewed Staff #1 during inspection. Per Staff #1, they did not observe the child fall. Per Staff #1 they did observe the child to be playing and running throughout the day. Per Staff #1, Child did not complain about his ankle until the end of the day when mother arrived. LPA also interview Staff #2. Staff #2 did observe the child fall during the morning outdoor play time, but child continued to play and did not cry or complain about his foot. Staff #2 is child's teacher. Staff #2 also stated child was fine throughout the day and did not complain about his foot until the afternoon during pick up. Staff #2 stated that they did not observe the foot to be swollen or bruised. Report continues on the next page

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

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

FACILITY NAME: CHILDTIME CHILDREN'S CENTER	FACILITY NUMBER: 191871812
	VISIT DATE: 07/13/2023

NARRATIVE

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Based on all information obtained on this date, and interviews conducted with staff, no follow-up is necessary regarding the incident. The incident appears to be an unusual accident. It appears to be nothing the facility staff could have done to prevent the incident from occurring.

There were no deficiencies observed in regards to today's visit. Exit interview was conducted with Director Ana Fragoso. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

LIC809 (FAS) - (06/04)

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