191870904-8-5-2024-54-CC-KCHE-D7UU8G-20240805152132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191870904
Report Date: 08/05/2024
Date Signed: 08/05/2024 03:21:42 PM

Document Has Been Signed on 08/05/2024 03:21 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:	WADSWORTH AVENUE EARLY EDUCATION CENTER		FACILITY NUMBER:	191870904
ADMINISTRATOR/ DIRECTOR:	HUMBERTO BENITEZ		FACILITY TYPE:	850
ADDRESS:	1047 EAST 41ST STREET		TELEPHONE:	(323) 232-0581
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90011
CAPACITY: 111	TOTAL ENROLLED CHILDREN: 0	CENSUS: 51	DATE:	08/05/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Facility Representatives		TIME VISIT/ INSPECTION COMPLETED:	03:40 PM

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On 08/05/2024 at 2:30 PM PM Licensing Program Analyst (LPA) Katrina Chicote conducted an Unannounced Case Management - Incident inspection to follow up on an incident that was reported to The Department on 06/26/2024. Upon arrival, LPA met with a variety Facility Representatives (FR). Census was taken. Per FR, Principal was at a training on this date.

On 06/26/2024, an incident was reported to The Department where a child sustained an injury at the facility that required medical attention. The facility reported this incident to The Department within the required 24 hours and submitted a written report via email.

During this inspection LPA interviewed Teacher who observed the incident and conducted observation of where incident took place. LPA observation of classroom did not observe any hazards or obstructions around where incident took place. Teacher state that child was sitting on rug during circle time and leaned back when another child leaned back on them which resulted in the injury. Teacher states she observed incident and provided immediate first aid which included providing ice pack and sling for the child, teacher also assessed injury and observed child not being able to move elbow without pain. Teacher states parent was called and Teacher advised parent to take to doctor. Child was taken to the doctor where it was confirmed that child suffered a hairline fracture, child returned to school with restrictions. Child was already picked up during today's inspection but multiple staff confirm that child's arm is no longer in a sling and she's back to regular activities. Based on the information obtained, there was no violation of personal rights, there was adequate supervision at time of incident, and immediate first aid and response was provided.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 08/05/2024.

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

Exit interview was conducted and report was reviewed with the Facility Representative, Jessica Ramos.
Report Ends - Page 1 of 1

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024

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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