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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411204
Report Date: 11/06/2024
Date Signed: 11/06/2024 03:42:37 PM

Document Has Been Signed on 11/06/2024 03:42 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:PACE - GREEN HEAD STARTFACILITY NUMBER:
197411204
ADMINISTRATOR/
DIRECTOR:
BEATRICE PREYERFACILITY TYPE:
850
ADDRESS:4540 W. 168TH STREETTELEPHONE:
(310) 370-6345
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY: 18TOTAL ENROLLED CHILDREN: 116CENSUS: 14DATE:
11/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH: Nilda Santiago- Site LeadTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 11/6/2024 at 1:30 p.m. Licensing Program Analyst (LPA)Doris Whitmore conducted an unannounced visit for conducting a Case Management Inspection due to an incident that occurred on 10/10/2024 and was reported to the Regional Office. LPA met with Nilda Santiago Site Lead and informed the nature of the visit. LPA observed 14 Children in care with proper teacher/child ratios observed. There was a total of 2 staff.
According to the UIR, Prgram Coordinator reported Child 1( C1) was standing on the couch inside the classroom and C1 fell backwards, hitting the upper back part of his head on a bookshelf. Staff applied an ice pack and notified parents. Parent arrived to the facility to observe C1. Parent coordinator does not know if parent will take C 1 to the doctor.

During the investigation LPA Whitmore obtained a copy of the Head Injury Precaution Sheet, & Incident Report. LPA conducted a file review and classroom observation of the couch. LPA Whitmore interviewed the teacher and the child. Based up on interviews S1 stated that the child was not standing on the couch when he fell back and hit his head. C1 was sitting down with two cars in his hand. The class was transitioning for handwashing for lunch. C1 with the cars in his hand tilted his body to the left and hit his head, Ice pack was applied and the parent was called. S1 during the interview was able to demonstrate to LPA Whitmore How C1 fell. Parent did not taker C1 to the doctor. C1 was absent the next day. and returned back to school on October 15, 2024.
Based on interviews and documentation obtained there was no lack of supervision. There are no violations of Title 22 Regulations, no deficiencies cited. An exit interview was conducted with the Site Lead Nilda Santiago. A copy of this report, Notice of Site Visit, & Appeal Rights were issued.
Karren StarksTELEPHONE: (310) 740-3038
Doris WhitmoreTELEPHONE: 424-301-3029
DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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