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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018969
Report Date: 10/04/2023
Date Signed: 10/04/2023 12:13:57 PM


Document Has Been Signed on 10/04/2023 12:13 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:LBUSD-POWELL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198018969
ADMINISTRATOR:NANCY PEREZFACILITY TYPE:
850
ADDRESS:150 VICTORIA ST.TELEPHONE:
(310) 631-8987
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:48CENSUS: 32DATE:
10/04/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Margarita Prosinski- Lead Teacher & April TuckerTIME COMPLETED:
12:33 PM
NARRATIVE
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced Case Management inspection at the above facility on 10/04/20223 at 9:25 AM. LPA met with Margarita Prosinski, Facility Representative (FR) who guided analyst on a tour of the facility. There were 32 children and six staff present when LPA arrived.

The purpose of the visit is to address an Unusual Incident reported to the Department on 9/22/23. The incident involved a child who wondered away from his classroom for approximately 15 minutes.



During today's inspection LPA Navarro conducted interviews with Staff present during the incident. According to Staff #1, at approximately 2:00 PM , during dismissal time kids were sitting down on rug waiting to be called by teacher whose parents were there for pick up. Staff #1 noticed that child was missing and looked on sign in/out sheet and noticed that child had not yet been picked up realizing then that they were missing a child. Staff #1 instructed Staff #2 to stay with the children while they notified the office of the missing a child and go through every gate of exiting notifying everyone of the missing child. Staff #1 believes the child wandered off during a time she was talking to another parent. Child was found by a parent and handed child to the elementary school staff. Child was found approximately half a mile away near on Long Beach Boulevard. Staff #1 approximates that the child was unsupervised by CDC staff for a period of 15 minutes.

LPA Navarro also interviewed the Principal for Powell Elementary School who confirmed the location of where the child was found.

Based on the information obtained, LPA has determined that there was a lack of care and supervision that occurred when child managed to leave the classroom unnoticed. See the attached LIC 809D for the deficiency cited. Exit interview was conducted with facility representatives Margarita Prosinski and April Tucker.
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SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023
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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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: LBUSD-POWELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198018969
VISIT DATE: 10/04/2023
NARRATIVE
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A copy of the Notice of site visit & type A citation report must be posted for 30 consecutive days, failure to maintain posting as required will result in a $100.00 civil penalty. A copy of this report must be provided to the parent/guardian of children enrolled by the next business day or immediately upon return. A copy of this report must also be provided to the parent/guardian of any newly enrolled children for the next 12 months. Parents must sign form LIC 9224, acknowledging receipt of the report. Form provided during this visit.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 10/04/2023 12:13 PM - It Cannot Be Edited

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: LBUSD-POWELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198018969

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/04/2023
Section Cited
HSC
101229(a)(1)

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101229-Responsibility For Providing Care and Supervision. (a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No children shall be left without the supervision, including visual observation, of a teacher at any time. This
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The facility has installed bells on each door. Facility has placed a staff at the gate and outside the door. There will be a staff training on precautions and safety measures and keeping count during dismissal. Facility Represantatives will provide LPA with a copy of the agenda of the meeting and roster of attendees.
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requirement was not met as evidenced by interviews. Child #1 managed to wonder away from his classroom without being noticed. Child was without visual supervision approximately 15 minutes. This is a immediate risk to the health and safety of the 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: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023
LIC809 (FAS) - (06/04)
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