<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401861
Report Date: 10/25/2024
Date Signed: 10/25/2024 10:27:39 AM

Document Has Been Signed on 10/25/2024 10:27 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:DAVID ROBERTI EARLY EDUCATION CENTERFACILITY NUMBER:
197401861
ADMINISTRATOR/
DIRECTOR:		LATRYCE JACKSONFACILITY TYPE:
850
ADDRESS:1156 E. VERNON AVE.TELEPHONE:
(323) 234-1428
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 103TOTAL ENROLLED CHILDREN: 103CENSUS: 53DATE:
10/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Guadalupe EstradaTIME VISIT/
INSPECTION COMPLETED:
11:00 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
On 10/25/24 at 9:00 AM Licensing Program Analysts (LPA) Claudia Kam conducted an Unannounced Case management Inspection to follow up on incidents that was reported to the Department. Upon arrival, LPA announced purpose of inspection and met with Facility Representatives, who granted entry to facility. Census was taken.
On 10/4/24, an incident was reported to The Department where a child sustained an injury while in care. The facility reported this incident to the Department within the required 24 hours and submitted written report within seven days.

During this inspection LPA interviewed staff, observed room and outdoor play space where incidents took place in, allergy postings, medication, and observed child named in report. Teacher informed Licensing that a child had an tiny bump on his head from being hit with a toy. Teacher stated this incident occurred during outdoor play. Teacher states they applied immediate first aid, by cleaning wound and applying ice, incident report and head injury report completed and parent notified immediately due to head injury. Teacher states that after child continued to play and injury did not appear to stop child from daily activities. At lunch a 2nd incident was reported where child was given the wrong lunch causing an allergic reaction. Parent was informed immediately and allergy medicine given to child per parent instructions. Parent was informed and child picked up after lunch time, ambulance was called due to child was stumbling. Paramedics concluded it was not due to head trauma and may be due to medication. Child did not seek additional medical care. Child returned to care the next school day. A supervision plan is currently implemented and a new one is currently being constructed to provide additional supervision. Facility is now having meals handed out to children with special menus directly by food services. LPA observed child present at the facility and playing freely not affected by any injury. Based on the information obtained and LPA observation LPA determined there was adequate supervision and Facility Representatives made necessary adjustments after incident and are pending further adjustments.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.
A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Facility Representative.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1