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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419605
Report Date: 06/04/2025
Date Signed: 06/04/2025 12:34:40 PM

Document Has Been Signed on 06/04/2025 12:34 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:PACE - EARLY EXPLORESFACILITY NUMBER:
197419605
ADMINISTRATOR/
DIRECTOR:		MARTHA HERNANDEZFACILITY TYPE:
850
ADDRESS:1200 S. MANHATTAN PLACETELEPHONE:
(323) 643-4850
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY: 55TOTAL ENROLLED CHILDREN: 48CENSUS: 31DATE:
06/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Silvia De La Rosa- Site LeadTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On 06/4/2025 at 9:00a.m. Licensing Program Analyst (LPA)Doris Whitmore conducted an unannounced visit for conducting a Case Management Inspection for an incident that occurred on 05/06/2025 and was reported to the Regional Office. LPA met with the Site Lead Silvia De La Rosa and explained the purpose of the visit .At the time of the visit there was 31 children and 11 teachers. According to the UIR children were playing outside time, and another child had thrown a block and hit child( C1) in the forehead. Area hit on forehead started to bleed. Teacher( S1) provided first aid and icepack. Mother Daisy Quigada picked child up and took him to be evaluated. Assistant director spoke to the mother of the child, had cut mended by doctors. Mother at this point isn't sure if she would like to bring the child back. but parent did share that the child is eager to return to school.( C1) was interviewed and able to share what happened to his head.

( S1) stated that We have zones, and we have Zone A which is on the upper side of the playground where the playground structure is. Zone B is the lower half of the grass area to the bike area. I was in charge of Zone B. I was helping a child because he was having an argument with two other children. One of the children were crying and I was talking to(C2). (C1) was helping another child to clean up. It turned into a competition, where (C1) started crying. (C2) had went to another area to play, I had held on to (C1) hand and told him he could go play at another area. ( C1) was just crying because he lost the cleaning competition. Another child was saying why (C2) was standing in front and pushed another child. I did not see (C2) come from behind the area that he was playing. I saw (C1) was crying and holding on to his head. I saw the block next to (C1). I asked (C2) what happened ( C2) that he was crying too that’s why he threw the block. I took (C1) and did first aid. Before the incident happened ( C1) was playing with the cones and kicking the soccer ball. ( S2) stated When we go outside there are two zones. Zone A and Zone B. I was in Zone A the upper side of the playground structure.(S1) was in Zone B the lower part of the playground. It was clean up time, and I let the children know to clean up and pick up all the toy’s on the floor.

Karren Starks
Doris Whitmore
DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: PACE - EARLY EXPLORES
FACILITY NUMBER: 197419605
VISIT DATE: 06/04/2025
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That’s when I noticed (C1) crying (C1). I was with the other children helping them clean up. I had the children to sit and drink their water, that’s when (S1) got to the upper side of the playground structure and let me know what happened. We applied the ice pack we let (C1) sit. We asked (C1) what happened, and he let me know what happened. First Aid was administered to ( C1) Parent was notified and given the head injury precaution sheet.( C1) went to the doctor and was cleared and the just got glue on the injury. Parent of ( C1) did not provide a copy of the doctor's note.
During the investigation LPA Whitmore conducted a file review and a walk thru of the incident that took place on the playground. LPA Whitmore obtained copies of the following documents: Head Injury Precaution Sheet, LIC 624( Unususal Incident/ Injury Report). Jira, and Service Contact Summary.
Based on interviews conducted there was no lapse of Care and Supervision. Therefore there are no deficiencies being cited. A copy of this report along with the notice of Site Visit and appeal rights was issued to Site Lead . LPA Whitmore informed the Site Supervisor that the Notice of Site Visit must be posted for 30 day.
SUPERVISOR'S NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC809 (FAS) - (06/04)
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