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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600650
Report Date: 03/19/2026
Date Signed: 03/19/2026 02:35:04 PM

Document Has Been Signed on 03/19/2026 02:35 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:STEPHEN S. WISE TEMPLE PRE-SCHOOLFACILITY NUMBER:
191600650
ADMINISTRATOR/
DIRECTOR:		JAYNE ROSENFACILITY TYPE:
850
ADDRESS:15500 STEPHEN S. WISE DR.TELEPHONE:
(310) 889-2248
CITY:LOS ANGELESSTATE: CAZIP CODE:
90077
CAPACITY: 300TOTAL ENROLLED CHILDREN: 88CENSUS: 82DATE:
03/19/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Jayne RosenTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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LPAs DeCondia Ferguson and Brittanee Cleveland conducted an unannounced case management visit on 03/19/2026 to discuss the unusual incident report (UIR) that the facility submitted. This incident occurred on 03/13/2026. LPAs arrived at the facility and met with Director Jayne Rosen who guided LPAs on a tour of the facility. Present were 82 preschool children in care and 21 staff. The LIC 624 stated:

On Friday, March 13, 2026, at approximately 1:40 PM, a child ran into a padded pole during outdoor play and fell. Staff responded immediately, contacting the school nurse and administration, who arrived promptly.

The reporting teacher noted the child was briefly unresponsive with minor body shaking lasting a few seconds. Upon assessment, the child was awake, coherent, and responsive. Ice was provided, and the child reported no pain. The nurse removed the child’s orthotic brace following consultation with the mother due to heat concerns.

Emergency protocols were followed, including contacting 911, security, and the child’s mother. The Fire Department assessed the child on-site; he was able to sit, stand independently, and remained calm, alert, and communicative throughout.

The child’s mother arrived, and as a precaution, paramedics transported the child to the hospital.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: STEPHEN S. WISE TEMPLE PRE-SCHOOL
FACILITY NUMBER: 191600650
VISIT DATE: 03/19/2026
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An environmental review confirmed the padded pole exceeded safety requirements, with over 3 inches of padding and soft pour surfacing beneath. Staff present included teaching staff, administration, and the school nurse.

At the time of transport, the child remained stable, calm, and in good spirits, and accompanied his mother cooperatively.

LPAs conducted interviews with staff about the unusual incident. Staff confirmed what took place in the reported LIC 624 was accurate. Staff further confirmed child had orthotic braces on at time of incident which he had only worn for two days. The day the incident took place was the second day of the child wearing orthotic braces. Upon further investigation it was stated no medical documentation was provided regarding orthotic braces. Administrator stated child has not worn orthotic braces since returning after incident. No medical documentation was provided upon child’s return to the facility. Administration contacted mom regarding incident and was informed the child had a concussion. No other documentation was provided upon child’s return. Child reported back to facility on Monday March 16, 2026. At the time of inspection LPAs observed child without orthotic braces and was actively participating with daily activities.

Director stated emails were sent to families regarding the incident due to children witnessing incident at the time. LPAs advised Director Jayne Rosen to provide training on heat illnesses and seizures to staff.

Based on staff reports, supervision was in place, ratios were maintained, and appropriate care and response procedures were followed. At this time, there is no indication of a violation of Title 22 supervision or safety regulations.

LPA Ferguson will conduct follow-up interviews with parent to gather additional information regarding the incident. Director provided LPA with parent's contact information.

Exit interview conducted with Director Jayne Rosen. Copy of report, notice of site visit, and appeal rights were provided.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
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