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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670722
Report Date: 03/20/2024
Date Signed: 03/20/2024 12:28:55 PM

Document Has Been Signed on 03/20/2024 12:28 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-GRANT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670722
ADMINISTRATOR:KIMBERLY KELLYFACILITY TYPE:
850
ADDRESS:6405 WALNUT AVETELEPHONE:
(562) 422-4686
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 44DATE:
03/20/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Coordinating Teacher - April TuckerTIME COMPLETED:
12:50 PM
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Licensing Program Analysts (LPAs) Susann Sanchez and Ashley Calderon conducted an unannounced case management inspection to follow up on several incidents that was reported to the Department. Upon arrival, LPAs met with Coordinating Teacher, April Tucker who provided LPAs a tour of the facility inside and outside. Census was taken.

On 03/18/24, an unusual incident report was made to the department regarding where Child #1 bite Child #2 on the stomach. Upon arrival, LPA's witnessed Child #1 being signed out by mother. Child #2 was interviewed and stated that incident happened in the play yard (tiny house) and that Staff #2 was standing right there and attended child immediately. LPA's observed play area were incident took place with Staff #1 (S1) and S1 was interviewed. Based on the information provided there was adequate supervision provided the day of the incident.

On 02/01/24, an unusual incident report was made to the department regarding a child took a fire extinguisher off the wall and threw it on 01/31/24. During today's visit LPA's followed up on case management visit conducted by LPA's on 2/16/24 due to LPA's witnessing fire extinguisher was not moved up higher to ensure safety of the children. Coordinating Teacher April Tucker called Administrator Cristabelle Rodriguez to follow up on the fire extinguisher. At 11:40am maintenance worker arrived at the facility to place fire extinguisher higher, LPA's stated to follow Long Beach Fire Marshall Instruction regarding placement for the fire extinguisher. Maintenance worked moved fire extinguisher higher during time of visit, LPA's observed fire extinguisher moved up higher to ensure the safety of the children.

All incidents were reported to the Department in a timely manner. Per California Code of Regulations, Title 5, no deficiency cited during time of visit.

Exit interview was conducted with Coordinating Teacher April Tucker. LPA's notified Ms. Tucker to post 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2024
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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