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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000639
Report Date: 03/21/2023
Date Signed: 03/21/2023 01:39:52 PM


Document Has Been Signed on 03/21/2023 01:39 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 INFANT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198000639
ADMINISTRATOR:ARIANA CHAVEZFACILITY TYPE:
830
ADDRESS:501 ATLANTIC AVETELEPHONE:
(562) 437-8991
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY:35CENSUS: 6DATE:
03/21/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:55 AM
MET WITH:Ariana ChavezTIME COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management Incident inspection. This inspection is regarding an incident that took place on March 8, 2023. LPA met with Site Supervisor Ariana Chavez who assisted with the inspection.

LPA conducted an interview with staff #1 who witnessed the incident first hand. Staff #1 indicated that child #1 was walking during free choice time and tripped falling forward (hitting the small shelf in the classroom) and sustaining an injury to the forehead. Staff #1 and in-house incident report indicate that there were three staff and five children present during the incident. Staff #1 indicated the child was approximately 5-6 feet away when the fall occurred.

As a result of the fall, child #1 sustained a bump 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 next day with no restrictions.

Staff followed the required protocol in terms of first aid and "reporting requirements" as the 3/8/2023 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 Ariana Chavez.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2023
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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