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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000638
Report Date: 10/29/2020
Date Signed: 10/29/2020 06:00:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:YOUNG HORIZONS CHILD DEVELOPMENT CENTERSFACILITY NUMBER:
198000638
ADMINISTRATOR:ARIANA CHAVEZFACILITY TYPE:
850
ADDRESS:501 ATLANTIC AVETELEPHONE:
(562) 437-8991
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:65CENSUS: 44DATE:
10/29/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:49 AM
MET WITH:Ariana ChavezTIME COMPLETED:
01:25 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management-Incident inspection. This inspection is regarding incident/injury that took place on August 31, 2020. Licensing Program Analyst met with Site Supervisor Ariana Chavez.

Staff #1 and Staff #2 guided LPA to the playground area where child #1 was injured. LPA observed the area to be clean, free of hazards and appearing to be in safe good condition. LPA also observed the playground equipment appeared to be age appropriate with platforms and slides approximately 3 to 4 feet high. Staff #1 indicated there were twelve children with two staff. Staff #1 also described that child #1 had a misstep on one of the playground equipment stairs. As a result of the misstep, child #1 fell and sustaining a cut on the forehead. Staff #3 was not in a position to see the incident however, Staff #3 indicated they observed the child was given first aid immediately after the incident occurred. After the child was given first aid, the child's parents were contacted.

Note: The child was taken to the doctor for medical treatment. Staff followed the required protocol in terms of first aid and "reporting requirements" as the 8/31/2020 incident was reported to Child Care Licensing within the required 24 hours. Information provided matches the incident report. Based on interviews and observations there were no violations of Title 22 requirements.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Site Supervisor Ariana Chavez.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020
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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