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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000638
Report Date: 01/27/2023
Date Signed: 01/27/2023 04:20:36 PM


Document Has Been Signed on 01/27/2023 04:20 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
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: 25DATE:
01/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:36 PM
MET WITH:Amber PimentelTIME COMPLETED:
04:40 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management Incident inspection. This inspection is regarding incident that took place on January 20, 2023. LPA met with Assistant Director Amber Pimentel who providing information and assistance for the inspection.

LPA conducted interviews with staff #1 who witnessed the incident first hand and staff #2. Staff #1 indicated that they (staff #1 and child #1) were playing with a ball and child #1 chased the ball and fell hitting her head on playground equipment. LPA also interviewed staff #2 who indicated that staff #1 was in the presence of child #1 during the incident. Staff #2 did not witness the incident first hand but did observe first aid treatment afterwards. Staff indicate that two staff were present providing care for about 11 children.

As a result of the fall, child #1 fell and sustaining a cut on the forehead. Staff #1 indicated that the child received first immediate first aid and the child's parents were contacted for pick up. The child was taken to the doctor for minor medical treatment and returned to school the very same day with no restrictions. LPA also observed the child playing during today's visit with no restrictions.

Staff followed the required protocol in terms of first aid and "reporting requirements" as the 1/20/2023 incident was reported to Child Care Licensing within the required 24 hours. Information provided matches the incident report. There were no corroborated disclosures which indicate that a Title 22 violation occurred regarding the incident.

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 Amber Pimentel.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2023
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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