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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191602055
Report Date: 11/04/2021
Date Signed: 11/04/2021 10:46:57 AM

Document Has Been Signed on 11/04/2021 10:46 AM - 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:DISCOVERY PRESCHOOL AT LAUCCFACILITY NUMBER:
191602055
ADMINISTRATOR:ROXANNA MENENDEZFACILITY TYPE:
850
ADDRESS:5550 ATHERTON STTELEPHONE:
(562) 596-2108
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 18DATE:
11/04/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Roxanna MenendezTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management Incident inspection. This inspection is regarding an incident that took place on October 22, 2021. LPA met with Director Roxanna Menendez who provided information and assistance during the inspection.

Staff #1 guided LPA to the playground to observe the playground equipment where child #1 was injured. LPA observed the equipment to be age appropriate, have no structural damage, and be less than five feet tall. The playground appeared to be in normal safe good condition. Staff #1 was approximately 12-15 ft away when she witnessed the child injury. Staff #1 and staff #2 indicated the child missed a grab bar on the monkeybars and fell back back hitting the head on a step bar. This caused the child to sustain a laceration. Staff #1 and staff #2 indicated that the ratio was one teacher to eight to nine students at the time.

Post injury, staff immediately conducted first aid, contacted parents and 911. The child was taken to the hospital for medical treatment and returned to school on October 25, 2021 with no medical restrictions. Staff followed the required protocol in terms of first aid and "reporting requirements" as the 10/22/2021 incident was reported to Child Care Licensing within 24 hours or next business day on 10/25/2021. The Information provided matches the incident report. Director Menedez indicated that this is the only injury she can recall on the monkeybars in thirteen years of working at the center. Based on interviews and observations there were no violations of Title 22 requirements.

Note: The facility is in discussion to remove the monkey bars. LPA informed Director Menendez that there may be better options as the monkey bars are metal and may be outdated preschool equipment. LPA advised to monitor children who may not have advanced motor skills if they decide to keep the monkeybars.
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 Director Menendez..
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2021
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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