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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009901
Report Date: 08/03/2023
Date Signed: 08/04/2023 08:20:05 AM


Document Has Been Signed on 08/04/2023 08:20 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:PETER MCGRATH CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198009901
ADMINISTRATOR:EVELYN CONTRERASFACILITY TYPE:
850
ADDRESS:2300 N. ONTARIO ST.TELEPHONE:
(818) 565-3572
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY:68CENSUS: 55DATE:
08/03/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Sandra MagdalenoTIME COMPLETED:
02:01 PM
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On 8/3/2023 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Case Management – Incident inspection related to a self-reported Unusual Incident Report (UIR) submitted on 7/11/2023. Upon arrival, LPA met with Sandra Magdaleno and explained the purpose of the visit.

LPA observed 55 children in care supervised 9 by staff members.

According to the UIR, on 7/7/23, child named on the report was walking down the stairs of the playground apparatus, child grabbed both rails and began swinging his body back and forth. Teacher Nancy was in front of the child and told him “ Oh Henry, you’re going to get hurt, please stop swinging”. Suddenly child lost his grip and fell backwards hitting the back of his head against the edge of the second step of the structure. Teacher approached Henry and noticed blood, child was check and cleaned up. Teacher notified director and parent.

During today’s inspection, LPA interviewed director, S. Magdaleno and teacher N. Argueta. LPA observed the outdoor space including the playground apparatus where
incident occurred. At this time, further investigation is needed.

An exit interview was conducted. A copy of this report (LIC 809) and Notice of Site Visit was provided.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:
DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/03/2023
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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