197402655-10-22-2024-30-CC-LCLN-DAAV3Z-20241022160535

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197402655
Report Date: 10/22/2024
Date Signed: 10/22/2024 04:05:45 PM

Document Has Been Signed on 10/22/2024 04:05 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	UCLA EARLY CARE & EDUC. UNI. VILLAGE C.C.C.		FACILITY NUMBER:	197402655
ADMINISTRATOR:	NEGIN ZOMORODI		FACILITY TYPE:	850
ADDRESS:	3233 S SEPULVEDA BLVD		TELEPHONE:	(310) 915-5827
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	90	CENSUS: 60	DATE:	10/22/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	NEGIN ZOMORODI, LEAD DIRECTOR		TIME COMPLETED:	01:00 PM

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On 10/22/2024 Licensing Program Analyst (LPA) Lisa Clayton arrived at the Child Care Center unannounced, to conduct a Case Management – Incident visit. LPA Clayton was greeted by Director Negin “Nikki” Zomorodi. LPA Clayton observed 60 children in care being supervised and cared for by 10 fingerprint cleared staff.

LPA Clayton toured the facility outside and inside or a Health and Safety inspection. LPA Clayton reviewed the child’s file and documents related to the ongoing observations on the child. LPA Clayton interviewed staff and attempted to interview the children involved in the incident.

Description of the incident: RP reported that on 10/15/2024 while outside (C1) started to push and slap another child (name not provided) as well as Ashley Blandon, teacher. RP further states that Ms. Blandon picked up C1 to move her away from the other child. C1 then bit Ms. Blandon. RP reported that Ms. Blandon’s arm was left bruised, raised skin and red.

Incident update: Per the teacher involved, C1 was pushing at and attempting to “swing away” C2 from the outdoor sink to wash her hands. S1 explained to C1 that it was C2’s turn to use the sink C1 began to hit her (S1) in her stomach. S1 told C1 that because she wasn’t being safe with her body (by hitting her) so S1 “bearhugged” C1 from behind and sat down with C1 to give her time to regulate herself child, and while sitting C1 bit S1 on the arm. S1 immediately reported the incident to S2, who reported it to S3 who called C1’s parents advising of the situation and requesting that C1 be picked up from school. C1 returned to school the following day.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: UCLA EARLY CARE & EDUC. UNI. VILLAGE C.C.C.	FACILITY NUMBER: 197402655
	VISIT DATE: 10/22/2024

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LPA Clayton instructed Lead Director Nikki, and Director Kasey to documents all incidents on the CCC’s ouch reports and have the parents signed acknowledging notification of the occurrence.

Based on the information obtained, interviews conducted and LPA's observations the staff handled the incident in compliance with Title 22 Regulations and Health and Safety codes for Child Care Centers. In addition, the facility reported the unusual incident in a timely manner; therefore, no Title 22 violations have occurred, and no deficiencies are cited.

Exit interview conducted and report was reviewed with Lead Director Nikki.

LPA Clayton posted Notice of Site visit which to the remain posted for 30 days.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC809 (FAS) - (06/04)

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