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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 12:00:49 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 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:
12:15 PM
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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 10/22/19, the Department received an unusual incident/injury report regarding an incident on 10/21/19 involving Child #1. Per the report Child #1 was lining up outside in the sand yard when she tripped and hit the side of her right eye on the edge of a brick planter.

During the visit LPA conducted an interviews with Teacher #1 and Teacher #2. During interviews it was found that while on the playground Teachers called for clean up time so the children could line-up and return to class. During this time Child #1 jumped from the sand box, when the child jumped from the sandbox she slipped, causing her to hit her right eye on the edge of a brick planter in the playground. Per Teacher #1 after the child slipped she went over and picked the child up and rendered first aid. Per Interview with Teacher #1 she applied pressure with a paper towel until the bleeding stopped then brought the child into the office where ice was applied. Per Teacher #1 and Teacher #2 the child's parent was notified and the child was picked up and taken to the Hospital. Per Director Child #1 received 2 stitches. Per Teacher #1 the child returned to school the next day on 10/22/19.

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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