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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413773
Report Date: 08/22/2023
Date Signed: 08/22/2023 02:21:37 PM


Document Has Been Signed on 08/22/2023 02:21 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:ABC LITTLE SCHOOL WEST HOLLYWOOD, LLCFACILITY NUMBER:
197413773
ADMINISTRATOR:LANDA, ROZAFACILITY TYPE:
850
ADDRESS:927 NORTH FAIRFAX AVENUETELEPHONE:
(323) 654-9920
CITY:WEST HOLLYWOODSTATE: CAZIP CODE:
90046
CAPACITY:40CENSUS: 18DATE:
08/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:31 AM
MET WITH:Margaret Grandeldt, Co-DirectorTIME COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced site visit on 08/22/2023 for the purpose of a Case Management-Deficiencies.

LPA met with Margaret Grandeldt, Co-Director, who guided LPA on tour of the facility. There were 14 children and 2 staff present.

LPA Hernandez discovered that the facility did not report an incident that took place on 8/3/2023, where C1 was yelled at and handled in a rough manner by S1. Co-Director, Grandeldt disclosed to LPA during an interview that they were not aware of the reporting requirements.

The facility is not in compliance of reporting requirements because a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. As of 8/22/2023, there is no record of the report in the Department.

California Code of Regulations, Title 22, Division 12, Chapter 1, Article 02, Section 101212(d)(1)(C) Reporting Requirements is being cited on the attached 809D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Margaret Grandeldt, Co-Director.
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2023
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 2


Document Has Been Signed on 08/22/2023 02:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: ABC LITTLE SCHOOL WEST HOLLYWOOD, LLC
FACILITY NUMBER: 197413773

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2023
Section Cited
CCR
101212(d)(1)(C)

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Upon the occurrence, during the operation of the child care center of any of the events...a report shall be made to the Department by telephone or fax...In addition, a written report...Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
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Per Co-Director, facility will review reporting requirements with staff during a meeting. Co-Director will submit meeting agenda, attendance signatures to LPA by email by POC due date.
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This requirement is not met as evidenced by:
Based on interviews conducted, on 08/22/23, the facility did not report an incident that took place on 8/3/2023, where C1 was yelled at and handled in a rough manner by S1 which poses a potential Health or Safety, or Personal Rights risk to persons in care.
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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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2023
LIC809 (FAS) - (06/04)
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