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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006682
Report Date: 03/03/2021
Date Signed: 03/03/2021 04:50:30 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:LONG BEACH DAY NURSERY - EAST BRANCHFACILITY NUMBER:
198006682
ADMINISTRATOR:MONICA LOPEZFACILITY TYPE:
830
ADDRESS:3965 BELLFLOWER BOULEVARDTELEPHONE:
(562) 421-1488
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:95CENSUS: 28DATE:
03/03/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Margaret BlevinsTIME COMPLETED:
03:30 PM
NARRATIVE
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This case management inspection was conducted by Licensing Program Analyst (LPA) Warren Birks. Due to COVID-19 and precautionary measures, this inspection was conducted via teleconference with Director Margaret Blevins.

LPA conducted staff interviews regarding a self reported incident that occurred on February 24, 2021. Based on interviews, there was disclosure indicating that staff #1 released child #1 to individuals (in the parent pick up line) that were not authorized to pick up child #1. As a result of the miscommunication, child #1 was left outside the scope of visual observation for approximately one minute (until a parent notified another staff member). The facility is cited for lack of supervision as their was a lapse in visual supervision by staff during the parent pick-up.

Director Blevins indicated that the facility will implement new procedures and training regarding the parent pick up process this week. Note: The facility reported the incident to Child Care Licensing within a timely manner (24 hours).

LPA advised Director Blevins that the facility is required to provide a copy of this report to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months. The Licensee will obtain signature and date from the child’s parent/guardian on the Acknowledgement of Receipt of Licensing Reports, LIC 9224 (form provided).

Exit interview conducted with Director via teleconference. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt to confirm receipt of the report and to act as the signature on the report.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONG BEACH DAY NURSERY - EAST BRANCH
FACILITY NUMBER: 198006682
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/03/2021
Section Cited

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Responsibility for Providing Care and Supervision: The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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This requirement was not met as evidenced by: Staff #1 released child #1 to individuals in the parent pick up line who were not authorized to pick up child #1. This resulted in child #1 being without visual supervision for approximately one minute (until a parent informed staff). This is an immediate risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2021
LIC809 (FAS) - (06/04)
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