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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191871007
Report Date: 04/20/2022
Date Signed: 04/20/2022 02:04:20 PM

Document Has Been Signed on 04/20/2022 02:04 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CHILDREN'S COLLECTIVE, INC. THEFACILITY NUMBER:
191871007
ADMINISTRATOR:CHENIEKA MORGAN-MILLFACILITY TYPE:
850
ADDRESS:3817 S. SAN PEDRO ST.TELEPHONE:
(323) 231-1367
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 24DATE:
04/20/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Tameka Devine. Site SupervisorTIME COMPLETED:
01:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mayra Rivera conducted a Case Management inspection to follow up on the self reported incident that occurred on 2/24/22. LPA met with Site Supervisor Tameka Devine who guided the LPA on a tour of the facility. At approximately 12:20 p.m. LPA observed 17 preschoolers in classroom Full Day 1 with two staff members getting ready for nap and at approximately 12:25 p.m. LPA observed 7 preschoolers in classroom Full Day 2 with two staff members and children napping.

Based on the information that was gathered through interviews, it revealed that, the child was left in the playground unsupervised for 6 minutes and child appeared to be distress. Based on the available information it does appear this incident is a result of a Title 22 violation for lack of care and supervision. The facility has been cited and given a deficiency.

The content of this report was read and discussed. An exit interview was conducted with Site Supervisor Tameka Devine; the notice of site visit must be posted for 30 days upon receipt and appeal rights were given and explained.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/20/2022
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 04/20/2022 02:04 PM - It Cannot Be Edited


Created By: Mayra Rivera On 04/20/2022 at 01:12 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHILDREN'S COLLECTIVE, INC. THE
FACILITY NUMBER: 191871007

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/20/2022
Section Cited
CCR
101229

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Responsibility for Providing Care and Supervision.

(a) The licensee shall provide care and supervision as necessary to meet the children's needs.

(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Per site supervisor a list of names of the children is given to the teachers to highlight as the children are departing. Dry erase boards are put up so that the teachers will keep track of number of children in classroom. Transition time from indoor to outdoor and outdoor to indoor. When children are in transition, attendance is taken.
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This requirement was not met as evidenced by: Based on information that was gathered through interviews, it revealed that, the child was left in the playground unsupervised for 6 minutes and child appeared to be distress. This poses an immediate health, safety, or personal rights risk to 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:Karen Chambers
LICENSING EVALUATOR NAME:Mayra Rivera
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022


LIC809 (FAS) - (06/04)
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