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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844072
Report Date: 08/09/2023
Date Signed: 08/09/2023 01:09:26 PM


Document Has Been Signed on 08/09/2023 01:09 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:SBCSS BRADACH STATE PRESCHOOLFACILITY NUMBER:
364844072
ADMINISTRATOR:NANCY ALVARADOFACILITY TYPE:
850
ADDRESS:15550 BELLFLOWER STREETTELEPHONE:
(760) 246-5016
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:24CENSUS: 16DATE:
08/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Leticia CastanedaTIME COMPLETED:
01:08 PM
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On August 9, 2023, Licensing Program Analyst (LPA) Babatunde Ibitoye met with Lead Teacher Leticia Castaneda to conduct an unannounced case management inspection. The purpose of the case management was to follow up on a self reported unusual incident report (UIR) submitted to the Department on May 26, 2023

Description of incident: On 5/19/23 at 11 am parents of C#1, came to the school to ask questions about a possible injury at school. They stated that on 5/18/23 at approximately 4:00 pm C#1 was crying and complaining that ''it hurt''. They noticed a fresh cut on C#1 private area and C#1 told them that she had fallen from the swings at school.They took her to the doctor and the doctor suggested they call the police. on 5/23, Deputy came to the school and asked for a statement, and provided a case number. C#1 did not attend school on 5/19 or 5/22 but did return on 5/23.

On the date of the alleged incident,5/18 there were 21 students, and 4 staff members present. All students were visually supervised throughout the day as were overstaffed. All staff confirmed that C#1 did not obtain any injury nor was she playing on the swings after the outdoor play ended at noon, C#1 behavior was normal, and did not express any pain. Upon departure, C#1 left normal and did not express any pain. CPS was contacted on 5/26/23.

During this investigation, LPA interviewed staff and Child #1 parent. LPA was guided on a tour of the playground. Further investigation is needed.

An exit interview was conducted, and a copy of this report was read and provided to the Lead Teacher Leticia Castaneda along with a Notice of the Site Visit

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
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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