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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191670722
Report Date: 05/14/2024
Date Signed: 05/14/2024 02:35:57 PM

Document Has Been Signed on 05/14/2024 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-GRANT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191670722
ADMINISTRATOR/
DIRECTOR:		KIMBERLY KELLYFACILITY TYPE:
850
ADDRESS:6405 WALNUT AVETELEPHONE:
(562) 422-4686
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 31DATE:
05/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Teacher Ms. Fortenberry/ CT April Tucker TIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Licensing Program Analysts (LPAs) Jeanette Estrada and Jonnisha Culbert conducted an unannounced case management inspection to follow up on incidents that were reported to the Department. Upon arrival, LPAs met with Teacher, Felicia Fortenberry. LPAs informed Ms. Fortenberry of the reason for the visit. LPAs observed a total of 31 children with 6 staff. Coordinating Teacher (CT) April Tucker arrived at a later time and continued with the visit. LPAs informed CT of the reason for the visit.
On 3/22/24 an unusual incident report was submitted to the Department regarding a remodel of the kitchen. Per CT, only one classroom (Classroom 35) was moved to a bungalow on site. The bungalow is a licensed classroom (classroom 31). At this time, the bungalow is being utilized only in the morning time and the regular classroom is utilized beginning at nap time. Per CT, the kitchen is awaiting the floor to be replaced for the remodel to be finished. LPAs observed the bungalow currently being used. No hazards were observed.
On 4/25/24 it was reported that Child 1 bit Child 2 on the stomach. The incident occurred on 4/24/24. Per interviews with staff, Child 1 ran towards Child 2 and bit them on the stomach over a toy. Per Staff 1, they witnessed the incident occur and stated it happened quickly. Per other staff interviews, Child 2 interacts with Child 1 frequently. Per Staff, Child 1s biting behavior is being monitored. Staff are working with Child 1 by providing one on one supervision, shadowing, redirecting unwanted behaviors, meditation, identifying triggers such as transitions and allowing child to assist with transitions. During this incident, Child 2 was provided with an ice pack and parents were notified.
On 4/29/24 an unusual incident was reported regarding an outbreak of hand, foot and mouth disease. Per staff interviews, the outbreak did not occur in the child development program, it occurred in the School Age Care (SAC) program that is not licensed under CCLD. Per CT, there were no hand, foot and mouth diagnoses in the child development program classrooms.
On 5/7/24 an unusual incident was reported to the Department regarding a child (Child 3) who fell off the climbing structure. On 5/6/24, Child 3 was playing on the climbing structure in the yard. Per staff interviews, Child 3 was holding onto a bar and must have let go, causing them to fall and land on a metal section of the structure.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LBUSD-GRANT CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191670722
VISIT DATE: 05/14/2024
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Per Staff 2, they were walking by and saw Child 3 on the bar but did not see the moment they fell. Per Staff 2, once Child 2 fell, they ran to them and helped pick them up. Child was provided an ice pack and parent was contacted. Per Staff 3, they were also outside and recall seeing Child 3 on the structure but did not see the moment they fell off. Per Staff, child returned to school with no restrictions from doctor. Per Staff, children are reminded to not jump off the structure.

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: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
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