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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018562
Report Date: 02/22/2024
Date Signed: 02/22/2024 04:03:43 PM


Document Has Been Signed on 02/22/2024 04:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:COVINA DEVELOPMENT CENTERFACILITY NUMBER:
198018562
ADMINISTRATOR:SHEENA MINAYAFACILITY TYPE:
830
ADDRESS:437 W. SAN BERNARDINO RD. #111TELEPHONE:
(626) 967-7153
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY:33CENSUS: 8DATE:
02/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Program Director Sheena MinayaTIME COMPLETED:
04:15 PM
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At approximately 12:50 pm Licensing Program Analyst (LPA) Mary Silva conducted an unannounced case management inspection to follow up on an incident that was reported to the regional office on 02/16/24. At the time of arrival licensing staff met with Program Director Sheena Minaya. The purpose of the inspection was explained. There was a total of 8 children present with 4 staff.

The department was made aware of an incident that occurred at the facility on 02/16/24 involving a child with serious injury needing medical attention. Facility called the regional office on 02/16/24 to report the incident and submitted a written report on 02/20/2024.



During the inspection LPA conducted interviews with Program Director, Clinical Director, Staff #1, and Staff #2. Based on the disclosures made during the interviews incident occurred in the infant playground at approximately 11:00am. Two teacher and two interns were present with seven children. Staff #1 was holding two children one on each side when they realized child #1 had caught the left ring finger in the hinges of the wrought iron gate. Clinical director was outside the preschool playground which is adjacent to the toddler playground when staff #1 called for assistance. Clinical Director took child to the classroom restroom to wash finger and applied pressure. Office staff called 911 and parents of child. Child #1 was transported to County USC for medical attention with parent. LPA obtained documentation in the form of facility roster, personnel report, sign in sheet for the month of February 2024, copy of incident report provided to parent, reviewed file for child #1, viewed video footage, angle of camera does not capture incident, photographs of the wrought iron gate were taken and other documents pertaining to the incident.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights were given.

Exit interview conducted and report was reviewed with Program Director Sheena Minaya.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary SilvaTELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2024
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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