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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417850
Report Date: 01/21/2025
Date Signed: 01/21/2025 12:40:54 PM

Document Has Been Signed on 01/21/2025 12:40 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CCRC HEAD START - CDI CANOGA PARKFACILITY NUMBER:
197417850
ADMINISTRATOR/
DIRECTOR:		ARMINE BAGUYMANFACILITY TYPE:
850
ADDRESS:7260 OWENSMOUTHTELEPHONE:
(818) 704-5207
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY: 17TOTAL ENROLLED CHILDREN: 16CENSUS: 13DATE:
01/21/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:29 AM
MET WITH: Myra Zaragoza- Center DirectorTIME VISIT/
INSPECTION COMPLETED:
12:45 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 01/21/2025 at 9:29 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 10/21/2024 and was reported to the Regional Office. LPA met with Myra Zaragoza , Center Director and informed the nature of the visit. At the time of the visit there was only 13 children and 2 teachers.

According to the UIR Early Learning supervisor states staff ( Claudia Larios)Child#1 loss balance when walking up the three cement stairs walking to a different part of the playground. Child#1 hit his right cheek, child started crying, teacher Priscilla Gomez helped child up. Teacher saw a bruise and a scratch on cheek. Teacher helped child up and put ice on it. Child#1 was fine and went back to playing Teacher #2 Priscilla called mom to let her know what happened. Mom picked up child about 12:00 p.m. after lunch. On 10/22/2024 mother took child to doctor, and mother said child was fine and had no restrictions. Child returned back to school.

LPA Whitmore interviews (C1). C1 is currently not enrolled at the facility and has transferred down the street to CCR Arthur Avila. LPA Whitmore asked the Center Director Why did the child transfer, Center Director stated that CCRC Arthur Avila has longer hours. LPA Whitmore was able to review the child's file. LPA Whitmore obtained from the file a copy of the LIC 624 Unusual Incident/ Injury Report, Head Injury Information,. Ouch Report, Emergency Department Doctor's Note.

LPA observed the out door area where (C1) lost his balance. LPA Whitmore observed the entire playground, the area that the child was playing in on the playground, and the three cement steps.

(S1) was able to demonstrate to LPA Whitmore where she was standing at on the playground. (S1) pointed to the area where the child was playing in and how the child walked up the three cement stairs and fell forwards. (S1) was positioned by the water table.(S2) was able to demonstrate where she was positioned on the playground. (S2) was positioned at the back of the playground. when ( C1) fell.. At the time of the incident there were three staff on the playground ( S3) was absent today..

Karren StarksTELEPHONE: (310) 740-3038
Doris WhitmoreTELEPHONE: 424-301-3029
DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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
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: CCRC HEAD START - CDI CANOGA PARK
FACILITY NUMBER: 197417850
VISIT DATE: 01/21/2025
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
26
27
28
29
30
31
32
 Based on information,, interviews, and documents obtained there was no lapse of Care and Supervision or violations of Title 22 Regulations. Copy of this report, Appeal Rights, and Notice of Site Visit was issued to the Center Director Myra Zaragoza.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2