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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414782
Report Date: 03/11/2020
Date Signed: 03/11/2020 03:04:10 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:FRANKLIN STATE PRESCHOOL RM.K-30FACILITY NUMBER:
197414782
ADMINISTRATOR:ALICE CHUNGFACILITY TYPE:
850
ADDRESS:2400 MONTANA AVENUETELEPHONE:
(310) 399-5865
CITY:SANTA MONICASTATE: CAZIP CODE:
90403
CAPACITY:19CENSUS: 12DATE:
03/11/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cassy Henry, Lead TeacherTIME COMPLETED:
12:30 PM
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On 03/11/2020 at 11:00 am, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced case management inspection at Franklin State Preschool RM K-30 located at 2400 Montana Avenue, Santa Monica, CA 90403 for the purpose of following up on the unusual incident that was self reported by the facility. The El Segundo Child Care Regional Office received the report on 02/24/2020.

According to the incident report, on 02/18/2020, child#1 told mother that sometime before Christmas, child was playing in the play area during class time and child #2, child#3, child#4 and child#5 pushed child#1 to the ground and put their fingers in child's "butthole". The parent reported the incident to the Mental Health Consultant on 02/18/2020 at 4:00 pm during a group session. The consultant notified the supervisor who notified the Director of Child Development Services (CDS).

During this inspection, LPA conducted a telephonic interview with the Director of Child Development Services and conducted an interview with staff#1. LPA also reviewed the child's file. LPA was unable to interview the children involved in the incident as the children had already left for the day.


At this time, further investigation is needed.

An exit interview was conducted with Cassy Henry, Lead Teacher.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020
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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