191890387-10-20-2022-58-CC-SMAZ-CKDTP8-20221020145355

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191890387
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:54:03 PM

Document Has Been Signed on 10/20/2022 02:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LAUREL EARLY EDUCATION CENTER		FACILITY NUMBER:	191890387
ADMINISTRATOR:	GEORGE, BARBARA		FACILITY TYPE:	850
ADDRESS:	8023 WILLOUGHBY		TELEPHONE:	(323) 654-0812
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	117	CENSUS: 34	DATE:	10/20/2022
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Principal Karen Paysinger		TIME COMPLETED:	03:00 PM

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	On 10/20/2022, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced Case Management visit at Laurel Early Education Center located at 8023 Willoughby, Los Angeles, CA 90046, to follow up on the self-reported incident that occurred on 10/17/2022. The telephone incident report was received in the El Segundo Child Care Regional Office on 10/17/2022. Karen Paysinger, Principal, self-reported that a three-year-old female child had wandered away from the facility on 10/17/2022. LPA met with Principal Karen Paysinger and discussed the purpose of the visit. LPA observed 34 children in care during this inspection. According to the report, on 10/17/2022 at approximately 12 noon, Child #1 was found outside of the school. The child was discovered by the school attendant. The child used the push bar to exit a gate during a restroom transition. During this visit, LPA obtained the following records: Unusual Incident Report (LIC 624), sign in and sign out sheets dated 10/17/2022-10/20/2022, facility sketch, and declarations forms from School Attendant, Staff #1, Staff #2, and Staff #3. LPA also conducted interviews with facility staff and conducted a tour of the facility. Based on the information gathered throughout the course of the investigation, it was revealed that Child #1 wandered out of the bathroom during transition time. The child exited the school property and made it to the sidewalk on the corner of Willoughby Ave. and Edinburgh Ave., unbeknownst to teaching staff members. The child was found by School Attendant around 12 noon and alerted the Principal. Principal then brought the child back to the classroom. This incident occurred during restroom transition around lunch time. It is unclear the exact moment the child exited the classroom area. Facility staff also unaware of how child exited the school grounds.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LAUREL EARLY EDUCATION CENTER	FACILITY NUMBER: 191890387
	VISIT DATE: 10/20/2022

NARRATIVE

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Based on the information obtained, there is a preponderance of the evidence to issue the following deficiency:

Type A citation in violation of Title 22 CCR Division 12 101229 (a)(1). Responsibility for Providing Care and Supervision. 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. (See LIC 809-D for deficiency page).

Upon receipt of this report, the Licensee shall post the Notice of Site visit and any licensing report documenting a type “A” deficiency. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent.

Exit interview conducted and Appeal Rights and Notice of Site Visit were provided to Principal Karen Paysinger.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/20/2022 02:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LAUREL EARLY EDUCATION CENTER	FACILITY NUMBER: 191890387
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/20/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/20/2022 Section Cited	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision. 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. This requirement is not met as evidenced by: On 10/17/2022 at approximately 12 noon, Child #1 was found
	8 9 10 11 12 13 14	outside of the school grounds. The child was discovered by the school attendant on the sidewalk on the corner of Willoughby Ave. and Edinburgh Ave. Staff members were not aware that child had exited the school grounds. This is a Type A citation and poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC809 (FAS) - (06/04)

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