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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191601954
Report Date: 07/25/2024
Date Signed: 07/25/2024 05:44:11 PM

Document Has Been Signed on 07/25/2024 05:44 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:UCLA EARLY CARE AND EDUCATION-INFANTSFACILITY NUMBER:
191601954
ADMINISTRATOR/
DIRECTOR:		MINOR, ALICIAFACILITY TYPE:
830
ADDRESS:101 S. BELLAGIO DR.TELEPHONE:
(310) 825-5086
CITY:LOS ANGELESSTATE: CAZIP CODE:
90095
CAPACITY: 60TOTAL ENROLLED CHILDREN: 21CENSUS: 11DATE:
07/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Alessandra Pinheiro, DirectorTIME VISIT/
INSPECTION COMPLETED:
06:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced case management inspection due to an incident that occurred on 07/08/2024 and 07/15/20254. LPA arrived at the facility at 08:15 AM and met with Alessandra Pinheiro, Director, who guided LPA on a tour of the inside and outside the facility. There were 11 children and 6 staff present upon arrival.

The purpose of the visit was to follow-up on two incidents that were reported to the Department.

LPA Calvillo conducted interviews and obtained documentation during this visit.

The first incident that occurred on 07/08/2024, was reported to the Department on 07/09/2024, via telephone. The facility Interim Director Rosaura Castillo reported the Unusual Incident to the Department within the required 24 hours of occurrence. The information reported to the Department indicated that facility staff observed rodent droppings on the floor of the Bunny Classroom, staff and children were relocated to another room for the day, the classroom was deep cleaned, and all equipment and toys were sanitized. Interim Director stated the classroom has been cleared to return to on 07/10/2024.

The second incident that occurred on 07/15/2024, was reported to the Department on 07/16/2024, via telephone. The facility Interim Director Rosaura Castillo reported the Unusual Incident to the Department within the required 24 hours of occurrence. The information reported to the Department indicated that Child #1 (C1) was fed cereal from the open container which contained rodent droppings. When staff poured the cereal into another bowl to feed Child #2, staff found the droppings and immediately stopped feeding Child #1.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
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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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: UCLA EARLY CARE AND EDUCATION-INFANTS
FACILITY NUMBER: 191601954
VISIT DATE: 07/25/2024
NARRATIVE
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Based upon information received from the interviews conducted it was determined that the food services of child #1 were violated when child #1 was fed cereal from the open container which contained rodent droppings. When the facility did not dispose of the contaminated food containers in a timely manner. This was an immediate risk to the health and safety of children in care.

The following deficiencies listed on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted with Alessandra Pinheiro, Director including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/25/2024 05:44 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 07/25/2024 at 04:29 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: UCLA EARLY CARE AND EDUCATION-INFANTS
FACILITY NUMBER: 191601954

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/26/2024
Section Cited
CCR
101227(a)(1)

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101227(a)(1) Food Services, (a) In child care centers providing meals to children, the following shall apply: (1) All food shall be safe... All food shall be selected, stored, prepared and served in a safe and healthful manner.
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Director stated the facility will use air tight containers for any open food product. LPA LPA observed the airtight containers in the classroom and cleared the plan of correction.
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This requirement is not met as evidenced by: when a child was fed food from a container which contained rodent droppings.
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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:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2024


LIC809 (FAS) - (06/04)
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