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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004654
Report Date: 12/03/2019
Date Signed: 12/03/2019 11:58:10 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LIGHTED WINDOW PRESCHOOL, INC.FACILITY NUMBER:
198004654
ADMINISTRATOR:SUZANNE JOHNSONFACILITY TYPE:
850
ADDRESS:1200 FOOTHILL BLVD.TELEPHONE:
(818) 790-8207
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY:103CENSUS: 83DATE:
12/03/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Suzanne JohnsonTIME COMPLETED:
11:13 AM
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On 12/03/19 Licensing Program Analysts (LPAs) Justin Dorsey and Bardo Baluyot conducted an unannounced case management for the purpose of addressing an incident that was reported to the Department. LPA met with Assistant Director Lara Stewart, who gave LPA a tour of the facility. Director Suzanne Johnson later arrived to the facility. During the visit there were 83 children present.

On 10/19/19, the Department received an unusual incident/injury report regarding an incident on 10/18/19 involving Child #1. Per the report during clean up time Child #1 was running in the room and ran into a low wooden bench, cutting her eyebrow.

During the visit LPA conducted interviews with Teacher #1 and Teacher #2. During interviews it was found that Child #1 was dismissed from snack time and began playing in the "house area". The child then ran over to the "block area" when she tripped hitting her head on a piece of furniture which holds the children's blocks. Per Teacher #1 it looked like the child sustained a minor cut as there was not much blood. As Teacher #1 took the child to the facilities kitchen to get a paper towel to apply pressure to the injured area, the cut opened up and began to bleed. According to interviews pressure was applied to the cut until the bleeding stopped then a ice pack wrapped in a paper towel was applied. The child's parent was notified and child was picked up and taken to the Emergency Room where she received 15 stiches. According to Teacher #1 the child returned to school on 10/21/19 .

Exit interview was conducted with Director Suzanne Johnson and Assistant Director Lara Stewart, The Notice of Site Visit and Appeal Rights were given.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019
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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