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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413312
Report Date: 12/11/2019
Date Signed: 12/11/2019 11:51:51 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:VOA/CESAR CHAVEZ HEAD STARTFACILITY NUMBER:
197413312
ADMINISTRATOR:PATRICIA GUZMANFACILITY TYPE:
850
ADDRESS:1269 NO. AVALON STREETTELEPHONE:
(310) 834-1839
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY:34CENSUS: 25DATE:
12/11/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Lakisha Seay-WhittikerTIME COMPLETED:
11:40 AM
NARRATIVE
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This is an amended report. On 12/11/2019 at 8:20 AM Licensing Program Analyst (LPA) Angelica Ramirez arrived at VOA/Cesar Chavez Head Start licensed facility for the purpose of following up on the unusual incident that occurred on 11/07/2019. The El Segundo Child Care Regional Office received the report on 11/08/2019 via phone call. LPA met with site supervisor Lakisha Seay-Whittaker. Upon arrival LPA observed 12 children on the playground (class 02/04) with two teachers, and 13 children in classroom 01/03 with two teachers.

According to the report, on 11/07/2019 at approximately 4:40 PM during transition from the playground to the classroom, Child #1 momentarily remained on the playground adjacent to the classroom. Staff retrieved him within a few minutes. The child remained on school premises during the incident.

During this inspection, LPA conducted interviews with staff. LPA conducted a tour of the classroom and playground, obtained facility records and a copy of the facility roster.

At the time of the incident there were two staff with 13 children in the afternoon class. Facility was operating within ratio at the time of the incident. However, the facility failed to provide proper supervision to Child #1 resulting in the child being left alone on the playground for less than five minutes. The facility did follow regulations in reporting the incident to the department in a timely matter.
Based on information obtained throughout the course of the investigation, a Type B citation will be issued today. The facility has since provided additional training on care and supervision, added additional staff in the afternoon, and added boards to the playground to assist with the counting of children.

Continued on page 2 (LIC809-C).
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VOA/CESAR CHAVEZ HEAD START
FACILITY NUMBER: 197413312
VISIT DATE: 12/11/2019
NARRATIVE
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This is an amended report.

An exit interview was conducted and a copy of this report, Appeal Rights and a Notice of Site Visit were provided to Lakisha Say-Whittaker, Site supervisor.

SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: VOA/CESAR CHAVEZ HEAD START
FACILITY NUMBER: 197413312
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/12/2019
Section Cited

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This is an amended report. Responsibility for Providing Care and Supervision. (a) The licensee shall provide care and supervision...to meet the children's needs. (1) No child(ren) shall be left without the
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supervision of a teacher. *This requirement was not met as evidenced by: based on interviews conducted, Staff left Child #1 alone on the playground. *This poses a potential health and safety risk to children in care.
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out loud. Facility also added an extra support staff in the afternoon. This deficiency was cleared during today's inspection. LPA obtained proof of the meeting and training during today's visit.

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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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3