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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010126
Report Date: 10/18/2022
Date Signed: 10/18/2022 10:03:13 AM

Document Has Been Signed on 10/18/2022 10:03 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:RALPH M. PARSONS PRE-SCHOOLFACILITY NUMBER:
198010126
ADMINISTRATOR:MARGARET MENDOZAFACILITY TYPE:
850
ADDRESS:841 W. MARTIN LUTHER KING JR.TELEPHONE:
(213) 763-5119
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY: 90TOTAL ENROLLED CHILDREN: 32CENSUS: 26DATE:
10/18/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Edwina Rambo, Child Care AssociateTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Katrina Chicote conducted an unannounced case management inspection on 10/18/2022 to follow up on an incident that was reported to the Department on 09/30/2022. Upon arrival, LPA met with Edwina Rambo, who provided LPA a tour of the facility and outdoor area where incident took place. Census was taken.

On 09/30/2022, an incident was reported to the department where a child fell while playing in the playground that resulted in a child seeking medical attention. The facility reported this incident to the Department within the required 24 hours and submitted written report within 7 days of call, following Title 22 Regulation Requirements.

During this inspection, LPA interviewed Child Care Associate and she informed licensing that incident occurred around 5:00pm to 5:15pm when child was playing with a ball during outside playtime. Child did complain about leg hurting and had to be carried to bench for observation, during this time Mom arrived and was informed in person of incident and was also provided Ouch Report. Mom took child to Orthopedic doctor who took an X-ray and informed facility that child suffered a fracture. Per Child Care Associate, there were staff that witnessed incident and was able to immediately attend to child. Per Child Care Associate, moving forward facility will only allow one group of children using outdoor play yard in the late afternoon and staff will monitor and allow for only small groups of 2-3 children for playing sports games. Staff will also be retrained in additional first aid. As of today, child has not yet returned to facility but does have older sister still attending. Facility has been in constant communication with mom for follow up.

Based on the information obtained and LPA observation of the play area and documents reviewed, LPA determined there was adequate supervision provided the day of the incident and proper follow up was also provided. No deficiencies will be cited in regards to this 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 conducted with Edwina Rambo.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2022
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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