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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493393
Report Date: 11/16/2023
Date Signed: 11/16/2023 10:20:11 AM


Document Has Been Signed on 11/16/2023 10:20 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:KREATIVE KIDS INFANT & TODDLER CENTERFACILITY NUMBER:
197493393
ADMINISTRATOR:ALFORD, ALYCEFACILITY TYPE:
830
ADDRESS:4925 WEST ADAMSTELEPHONE:
(323) 737-3449
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:7CENSUS: 5DATE:
11/16/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sade Williams, DirectorTIME COMPLETED:
10:30 AM
NARRATIVE
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On 11/16/2023, Licensing Program Analyst (LPA) Silva Garibyan conducted an unannounced case management inspection for the purpose of citing deficiencies observed during a complaint investigation for Complaint Control Number 58-CC-20230829093610. LPA met with Director, Sade Williams, and explained the purpose of the visit. During today’s visit, there were two staff providing care to five infants.
During the complaint investigation LPA obtained a copy of the camera footage and conducted interviews. When LPA reviewed the video footage provided, the two children ran to the crib room, one child slapped the other child, and they then ran back to the activity room. No teachers were observed in the crib room visually supervising the children and no one witnessed what occurred. When interviewed, staff explained that this happened during the transfer of the infants from outdoors to indoors and subsequently the teachers did not notice the incident. A child had sustained a bruise on the right ear as a result of being hit by another child in care.
The following Type A deficiency is being cited on 11/16/2023 in accordance to Title 22 of the California Code of Regulations:
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SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KREATIVE KIDS INFANT & TODDLER CENTER
FACILITY NUMBER: 197493393
VISIT DATE: 11/16/2023
NARRATIVE
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101429 Responsibility for Providing Care and Supervision for Infants (a)(1): infants shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.

Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Failure to maintain posting as required will result in a civil penalty of $100.00

A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.
The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

A copy of this Report (LIC809 and LIC809-D), Notice of Site Visit, and Appeal Rights (LIC 9058), was provided and explained to Sade Williams, Director.



Exit interview conducted with Director Sade Williams

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SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 11/16/2023 10:20 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: KREATIVE KIDS INFANT & TODDLER CENTER
FACILITY NUMBER: 197493393

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/16/2023
Section Cited
CCR
101429(a)(1)

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Responsibility for Providing Care and Supervision for Infants: infants shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.
This requirement is not met as evidenced by: Based on the review of the video

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The Director will conduct an In-Service training with staff with emphasis on visual Supervision and watch the “Supervising children in childcare” video at CCLD.childcarevideos.org.
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and interviews, staff did not provide care and supervision necessary to prevent C1 from sustaining bruise on their right ear after being hit by another child in care, which poses an immediate Health or Safety, or Personal Rights risk to persons in care.

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 Director will provide a copy of training agenda, sign in sheet, submit a LIC 855 Declaration, via email summarizing the regulation and information learned in the video to LPA no later than 11/29/2023


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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: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023
LIC809 (FAS) - (06/04)
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