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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870549
Report Date: 11/19/2024
Date Signed: 11/19/2024 11:06:20 AM

Document Has Been Signed on 11/19/2024 11:06 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BROOKLYN AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870549
ADMINISTRATOR/
DIRECTOR:		JESSICA ROBLES-LOGANFACILITY TYPE:
850
ADDRESS:329 N. ARIZONA AVETELEPHONE:
(323) 269-4085
CITY:LOS ANGELESSTATE: CAZIP CODE:
90022
CAPACITY: 114TOTAL ENROLLED CHILDREN: 78CENSUS: 66DATE:
11/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Office ManagerTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to an incident that was reported to the Department on November 7th, 2024. LPA met with Office Manager who guided LPA on a tour of the facility. Census was taken. Per Office Manager, Principal Jessica Robles-Logan is unavailable at this time. At 9:00 a.m., Office Manager was able to get in contact with the Principal over the phone, and LPA explained the reason for the visit.

On November 7th, 2024, an incident was self reported to the Department via Email by the facility who reported that a substitute teacher grabbed Child #1 by the arms to remove the child from the mud pit area.



All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incidents reported to the Department. During the inspection, LPA Valenzuela conducted interviews with staff, and obtained declarations from staff that was gather from the Principal on the day of the incident. Staff #2, #3, and #6 were not present for interview.

Regarding incident on November 7th, 2024 staff statements 2-3 corroborated that staff witness the incident involving Staff #6 with Child #1. Per Staff #2 and #3 statements disclosed that Staff #6 grabbed Child #1 by the upper area of the arms near the armpits and removed Child #1 from the mud pit area. Per Staff #3, they heard Child #1 crying and observed Staff #6 grabbing Child #1 by the arms and pulling them out of the mud pit area. According to staff statements 2-5 red marks were observed on Child's #1 inner arms. Staff #2 provided ice pack to Child #1 and parents were notified of the incident. Per Principal, they reviewed Child Care Licensing Personal Rights video with staff, and obtained signatures from staff that attended the training. ---------------------- pg. 1 of 2 ---------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BROOKLYN AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870549
VISIT DATE: 11/19/2024
NARRATIVE
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Statements disclosed that incident which occurred on November 7th, 2024 resulted in a child's personal rights being violated which is a potential danger for the health and safety of children in care.

Based on the LPA’s observations and records reviews, the following deficiencies listed on the attached LIC 809D (deficiency page) are 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 and safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative.

-------------------------------------------------pg. 2 of 2 ----------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/19/2024 11:06 AM - It Cannot Be Edited


Created By: Saul Valenzuela On 11/19/2024 at 10:38 AM
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: BROOKLYN AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870549

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/22/2024
Section Cited
CCR
101223(a)(1)

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101223 Personal Rights
(1) To be accorded dignity in his/her personal relationships with staff and other persons.


This requirement is not met as evidenced by:
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Per Director, they had a staff meeting to review Child Care Licensing Personal Rights video for children the day after the incident. Copy of signed attendance sheet was sent to LPA.
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Based on observation and interview, Staff #2 and #3 observed Staff #6 grabbing Child #1 against their own volition. This is a potential risk to the health, safety, and personal rights of children in care.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 11/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2024


LIC809 (FAS) - (06/04)
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