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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413379
Report Date: 08/06/2021
Date Signed: 08/06/2021 04:51:44 PM

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:ESTRADA FAMILY CHILD CAREFACILITY NUMBER:
197413379
ADMINISTRATOR:ESTRADA, ORALIA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 897-1769
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:14CENSUS: 4DATE:
08/06/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Oralia Estrada, LicenseeTIME COMPLETED:
05:00 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
At 4:00pm Licensing Program Analyst (LPA) Lisa Clayton conducted a case management visit to follow up on an Unusual Incident Report, received on 7/28/2021. LPA was greeted by licensee Oralia Estrada and her fingerprint cleared assistant Esther Barajas. Also present were 4 children in care.

The home was toured for a Health and Safety inspection. LPA asked to see the area were the incident took place. LPA observed a large grassy area just off of the concrete patio and asked licensee to describe what happened to Lincoln. Licensee advised that she was on vacation and that her assistant Esther was in charge. Per an LIC812 dated 7/1/2021, licensee informed her the Regional Office that she was going to be on vacation from July 12 - 23, 2021. I spoke to Esther who describe the incident as follows:

At approximately 12:40 pm Lincoln and another child were racing each other on the grass and where running toward the patio, Lincoln tripped over his own feet and landed on his right shoulder. Esther lifted him up and he was crying. She applied ice to his shoulder and he stopped crying. Esther called his mom, but no one answered. Esther then sent Mom a text, no answer. Mom responded to the text around 1:15pm and asked how he was doing. At the time Lincoln was playing with an IPad and was doing ok. He was moving his arm like normal. When mom arrived she asked him if he was ok and he said yes, and had him move his arm around and up and down. Esther wrote and ouchie report and mom signed. Lincoln was out the next day (Friday) and never returned.
Licensee received a call from the Resource and Referral Agency (Allies for Every Child) who informed her that Lincoln's mom reported that on Sunday, July 25, 2021 Lincoln was complaining about his shoulder and she took him to the hospital and he was diagnosed with a fracture. Mom was reporting that he would be out for at least one week, but he never returned. Mom came to the FCCH on Friday July 30, 2021 and signed the time sheets and thanked us for taking care of him. Mom informed licensee that Lincoln was going to be enrolled in a Child Care Center through Allies for Every Child.

LPA observed that The playground surface appears to be maintained and in safe condition, with sufficient cushioning underneath to absorb a fall. The playground equipment appears to be safe and there are ample age appropriate toys all of which are in good condition. LPA did not observe any dangerous items accessible today,


SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
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