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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191802184
Report Date: 06/15/2023
Date Signed: 06/15/2023 05:36:41 PM

Document Has Been Signed on 06/15/2023 05:36 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:WESTMINSTER CHILD CENTERFACILITY NUMBER:
191802184
ADMINISTRATOR:KANISHIA LONGFACILITY TYPE:
850
ADDRESS:4848 EAGLE ROCK BLVDTELEPHONE:
(323) 256-8086
CITY:LOS ANGELESSTATE: CAZIP CODE:
90041
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 25DATE:
06/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Director Kanishia LongTIME COMPLETED:
05:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Case Management- Incident investigation at the above facility on 06/15/23 at 02:15 p.m. A COVID-19 risk assessment was conducted prior to entering the facility. LPA wore appropriate personal protective equipment. LPA met with Director, Kanishia Long who guided LPA on a tour of the facility. Census was taken.

The purpose of this inspection is to follow up on an unusual incident report that occurred on 05/30/23. The facility reported this incident to the Department on 06/02/23 which was not within the required 24 hours.
During this investigation, LPA interviewed, staff #1 (S1 thru 2), children #1 (C1 thru 4), obtained a copy of facility roster and reviewed children’s files. Regarding the incident that occurred on 05/30/23, LPA will conduct a follow up required visit at a later date.

Based on the reporting requirements, the following deficiency listed on the attached LIC 809D (deficiency page) is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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, a civil penalty of $100 can be assessed.

Exit Interview was conducted, and appeal rights were given, along with a copy of this report was provided to the Director, Kanishia Long.


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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2023
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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Document Has Been Signed on 06/15/2023 05:36 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 06/15/2023 at 04:55 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WESTMINSTER CHILD CENTER
FACILITY NUMBER: 191802184

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/02/2023
Section Cited
CCR
101212(d)

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101212 Reporting Requirements:
(d) Upon the occurrence, during the operation of the child care center .. below shall be submitted to the Department within seven days following the occurrence of such event. This requirement is not met as evidenced by:
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Per Director, she will ensure that all incident reports will be reported to the department within the required 24 hours. Director understands that she must call the Officer of the Day and not the assigned LPA to report any unusual incidents.
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Facility did not report to the Department an incident that ooccurred on 05/30/23 within the required 24 hours. Report was received on 06/02/23.
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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:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2023


LIC809 (FAS) - (06/04)
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