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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870904
Report Date: 10/25/2024
Date Signed: 10/25/2024 11:58:43 AM

Document Has Been Signed on 10/25/2024 11:58 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:WADSWORTH AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870904
ADMINISTRATOR/
DIRECTOR:		HUMBERTO BENITEZFACILITY TYPE:
850
ADDRESS:1047 EAST 41ST STREETTELEPHONE:
(323) 232-0581
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 111TOTAL ENROLLED CHILDREN: 111CENSUS: 61DATE:
10/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Fay SimpsonTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 10/25/24 at 11:00 AM Licensing Program Analysts (LPA) Claudia Kam conducted an Unannounced Case management Inspection to follow up on an incident that was reported to the Department. Upon arrival, LPA announced purpose of inspection and met with Facility Representative, who granted entry to facility. Census was taken.

On 09/19/24, an incident was reported to The Department where a child sustained an injury while in care. The facility reported this incident to the Department within the required 24 hours and submitted written report within seven days.

During this inspection LPA interviewed staff, observed outdoor play area where incident took place, and observed child named in report. Teacher informed Licensing that a child bit a plant and had adverse reactions after consumption. Teacher stated this incident occurred at the end of play time when children were filing in and child notified staff that something was wrong with his mouth. Teacher states that child began to vomit, parent was called and notified immediately. Due to allergic reaction staff called paramedics who cleared child on site. No additional medical care was sought. Parent arrived immediately after notification and took child home and contacted poison control and child returned to school the next day. Per Teacher, plants are not poisonous and were moved out of children's reach. Plants observed out of reach from children on back wall. LPA observed child present at the facility and playing outside freely not affected by any injury. Based on the information obtained and LPA observation LPA determined there was adequate supervision and Facility Representatives made necessary adjustments after incident.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.
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.
Report Ends - Page 1 of 1

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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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