197413818-11-6-2024-30-CC-DWHE-DARRD6-20241106115524

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413818
Report Date: 11/06/2024
Date Signed: 11/06/2024 11:55:29 AM

Document Has Been Signed on 11/06/2024 11:55 AM - 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:	VOALA SANTA CRUZ HEAD START		FACILITY NUMBER:	197413818
ADMINISTRATOR/ DIRECTOR:	CANDELARIA CABRERA		FACILITY TYPE:	850
ADDRESS:	201 NORTH BEACON STREET		TELEPHONE:	(310) 831-3294
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90731
CAPACITY: 46	TOTAL ENROLLED CHILDREN: 44	CENSUS: 19	DATE:	11/06/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:45 AM
MET WITH:	Lashanda Kelly- Site Supervisor		TIME VISIT/ INSPECTION COMPLETED:	12:10 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	On 11/06/2024 at 8:45 a.m. Licensing Program Analyst (LPA)Doris Whitmore conducted an unannounced visit for conducting a Case Management Inspection due to an incident that occurred on 10/24/2024 and was reported to the Regional Office. LPA met with Lashanda Kelly, Site Supervisor and informed the nature of the visit. LPA observed 19 Children in care with proper teacher/child ratios observed. There was a total of 4 staff. According to the Unusual Incident/ Injury Report 10/24/2024 approximately 9:30 a.m. on the small playground Child#1 he was running and tripped on his own foot and fell on left side of body and he stood up on his own and he came to Site Supervisor and stated his left arm hurt bad. He was not able to raise the left arm up. The RP stated the arm looked like it was caved in of some sort. The child was taken to the office and given a sling to lift child arm up. Mother was called by Site Supervisor mother arrived at 11a.m. Mother took child to doctor. Mother was contacted this morning by Site Supervisor mother stated said child reinjured his same area and would most likely have to receive a cast on left arm. Child has not returned to school. Facility will complete a IHP Individual Health Plan which consist of Site Supervisor, Assistant, Mother and Medical Assistant who is located at the facility. During the investigation LPA Whitmore interviewed the Site Supervisor, Staff, and the child. LPA Whitmore obtained the Personnel Report, Doctor’s Note, Child Incident Report, & Individualized Health Care (IHP). Based up on interviews C1 was able to show me the area where he fell. S1 during the interview was able to tell LPA Whitmore that child was running around in circles throughout the playground. C1 fell on the artificial grass on his left side. C1 sat up and began to hold his arm. C1 stated that his arm hurts when he tried to lift it. C1 was able to wiggle his fingers. Site Supervisor asked C1 did he want an ice pack. C1 was brought into the office. C1 arm was put in a sling. Mother was called and staff was unable to get in touch with the mother. Grandmother was called and was able to get in contact with mom directly. There was an Individualized Health Care Plan (IHP) Child went to the doctor. Child returned to school on October 29, 2024, with a doctor’s note and restrictions. Child had reinjured the same arm that happened at home. S1 was able to show me where the incident occurred and where she was standing at.S2 stated that she was with another child when the incident occurred, and that she informed C1 to stop running.

Karren Starks	TELEPHONE: (310) 740-3038
Doris Whitmore	TELEPHONE: 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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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: VOALA SANTA CRUZ HEAD START	FACILITY NUMBER: 197413818
	VISIT DATE: 11/06/2024

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LA Whitmore went outside to the small playground and looked and took a picture of the artificial grass. LPA Whitmore did not see any items on the playground that could cause any harm to the children in care.

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 Site Supervisor Lashanda Kelly. A copy of this report, Notice of Site Visit, & Appeal Rights were issued.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	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

LIC809 (FAS) - (06/04)

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