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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493018
Report Date: 11/04/2022
Date Signed: 11/14/2022 09:15:45 AM


Document Has Been Signed on 11/14/2022 09:15 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:INGLEWOOD UNIFIED SCHOOL DISTRICT CHILD DEV. CTRFACILITY NUMBER:
197493018
ADMINISTRATOR:JOANNA CLIFTONFACILITY TYPE:
850
ADDRESS:10409 10TH AVENUETELEPHONE:
(310) 419-2691
CITY:INGLEWOODSTATE: CAZIP CODE:
90303
CAPACITY:131CENSUS: DATE:
11/04/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:43 PM
MET WITH:Joanna Clifton - Director of Child DevelopmentTIME COMPLETED:
05:44 PM
NARRATIVE
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On 11/4/2022 Licensing Program Analyst (LPA) Jillinda Chandler made an unannounced visit to Inglewood Unified School District Child Development Center for the purpose of following up on a reported unusual incident that was reported to the department by director Ms Clifton.

In regards to the incident that occurred on 8/10/2022 were a child was left in the restroom unsupervised.

Staff were interviewed, based on todays interviews it was disclosed that the child was left in the restroom and received assistance from an exempt employee (custodian) of the center.

An "A" citation was issued, the director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If facility was cited type A violations or complaint is found to be substantiated or unsubstantiated, a copy of the licensing report (LIC. 809 or LIC. 9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC. 9224 Acknowledgement of Receipt of Licensing Reports.

An exit interview was conducted, report was reviewed and shall be provided via email due to technical issues, along with the appeal rights and notice of site visit to director Joanna Clifton
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2022
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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Document Has Been Signed on 11/14/2022 09:15 AM - 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: INGLEWOOD UNIFIED SCHOOL DISTRICT CHILD DEV. CTR
FACILITY NUMBER: 197493018

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/04/2022
Section Cited

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101229(a)(1)Responsibilty for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any.....
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 time, Supervision shall include visual observation. This was not in compliance as evidence by interviews conducted with staff disclosed that the child was left in the restoom unsupervised

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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2022
LIC809 (FAS) - (06/04)
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