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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018752
Report Date: 05/03/2019
Date Signed: 05/03/2019 04:23:58 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:ECO HOUSE- PRESCHOOLFACILITY NUMBER:
198018752
ADMINISTRATOR:ALEXIS VAZQUEZFACILITY TYPE:
850
ADDRESS:2951 LONG BEACH BLVD.TELEPHONE:
(562) 997-8800
CITY:LONG BEACHSTATE: CAZIP CODE:
90806
CAPACITY:70CENSUS: 20DATE:
05/03/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Tonya Burns, Executive DirectorTIME COMPLETED:
04:30 PM
NARRATIVE
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An unannounced Case Management-Incident inspection was conducted on this date by Licensing Program Analyst (LPA) Jacqueline Martinez. The purpose for this inspection is to follow up on an incident that occurred on 4/5/19. The incident was reported to the Department by phone on 4/5/19. The Unusual Incident/ Injury Report (LIC 624) was received within the 7 days.

The incidents states that on 4/5/19 Child#1 was found alone by his father on the play yard and brought back to the classroom, a possible Lack of Supervision violation.

Upon arrival, LPA met with Tonya Burns, Executive Director. During today's inspection, interviews were conducted with 5 Staff members.

Based on the interviews conducted the facility failed to provide supervision to Child #1. During transition time from the play ground to the preschool classroom, 8 children were walking back to class with two Teachers. A third Staff member came to talk to the Teachers. When Child's 1 father came to pick up child, Child #1 was not in the classroom. Child #1 was found by the father alone in the play ground. This poses an immediate safety risk to the children care. LPA has deemed that the licensee is in violation of California Code of Regulations, Title 22 101229(a)(1) - Responsibility for Providing Care and Supervision, and is being cited on the attached LIC 809D.

Exit interview was conducted with Tonya Burns, Executive Director, and a copy of the report has been signed by and provided. Appeal Rights were explain and provided.

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SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: ECO HOUSE- PRESCHOOL
FACILITY NUMBER: 198018752
VISIT DATE: 05/03/2019
NARRATIVE
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Upon receipt of this report documenting a substantiated complaint allegation and a Type A deficiency, the Licensee shall do the following:
1. The Notice of Site visit and any licensing report (LIC 809) documenting a Type “A” deficiency shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.
2. A copy of this (LIC 809) report shall be provided to all the parents/guardians of children currently enrolled at the facility by the next business day or immediately upon return..
3. A copy of this (LIC 809) report shall also be provided to all the parents /guardians of any newly enrolled children for the next 12 months (1 year).
4. The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this visit.

5. The Plan of Correction (POC) also needs to be posted for the next 12 months.

SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: ECO HOUSE- PRESCHOOL
FACILITY NUMBER: 198018752
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/09/2019
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision: (a) (1) No child(ren) shall be left without the supervision of a teacher at any time.
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Executive Director states that a plan will be submitted to the Department by due date that details the steps the facility is taking to address the deficiency.
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Facility failed to provide supervision to Child #1 as evidence by: Child #1 was found by their father alone in the play ground, this poses an immediate safety risk to the children 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: Katherine HarewoodTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jacqueline MartinezTELEPHONE: 323 981-3384
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3