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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890351
Report Date: 10/06/2022
Date Signed: 10/06/2022 01:40:43 PM

Document Has Been Signed on 10/06/2022 01:40 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:GATES STREET EARLY EDUCATION CENTERFACILITY NUMBER:
191890351
ADMINISTRATOR:SCARLETT RAMIREZ-HOLGUINFACILITY TYPE:
850
ADDRESS:2306 THOMAS STREETTELEPHONE:
(323) 222-0277
CITY:LOS ANGELESSTATE: CAZIP CODE:
90031
CAPACITY: 114TOTAL ENROLLED CHILDREN: 52CENSUS: 34DATE:
10/06/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Principal, Scarlett Ramirez-HolguinTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced Case Management inspection due to an incident that was reported to the Department on October 4, 2022. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with Principal, Scarlett Ramirez-Holguin who guided LPA on a tour of the facility. Census was taken.

On October 04, 2022 an unusual incident report was made to the department regarding an incident that involved a child who was left unsupervised in the classroom. The facility reported this incident to the Department within the required 24 hours. Based on information obtained during interviews conducted with five (5) staff, LPA Garcia determined that on 10/03/22, child #1 was left unsupervised in classroom #2 and was found by the classroom door by Staff #1.



Although there were two (2) staff who was present providing care and supervision neither observed child #1 being left in classroom #2. One staff was assisting with transitioning children to another classroom and the other staff was assisting with a child’s departure. Child #1 was last seen inside the classroom by Staff #2 at 4:34 p.m. REPORT CONTINUES ON NEXT PAGE 1 OF 2.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GATES STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191890351
VISIT DATE: 10/06/2022
NARRATIVE
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LPA Garcia observed the classroom where child #1 was left and found. Child #1 did not exit the premises of the facility. Child #1 was observed opening the door of classroom #2 sometime approximately before 4:36 p.m. by Staff #1. Staff #2 and Staff #3 interviewed could not account for how this occurred.

Based on information obtained during this investigation and records review during today’s inspection, the following deficiency listed on the attached LIC809 deficiencies page is being cited in accordance with California Code of Regulations, Title 22, Division, 12, Chapter 1, Article 06, Section 101229(a)(1) Care and Supervision.

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


Exit interview conducted and report was reviewed with facility representative, Scarlett Ramirez-Holguin.

END OF REPORT: PAGE 2 OF 2.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/06/2022 01:40 PM - It Cannot Be Edited


Created By: Mireya Garcia On 10/06/2022 at 01:03 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: GATES STREET EARLY EDUCATION CENTER
FACILITY NUMBER: 191890351

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/14/2022
Section Cited
CCR
101229(a)(1)

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101229-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. This requirement is not met as evidenced by:
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Principal will submit to LPA a written proof that staff have reviewed this regulation, also submit a written plan on protocol that ensures staff coordinates effective care and supervision during classroom time and transitions as this will help to further ensure the Health and Safety of children in care.
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Based on LPAs review of documentation and interviews conducted, staff statements obtained during today’s inspection reveal that child #1 was left unsupervised in classroom #2 and was found in the classroom by Staff #1. This poses a potential health and safety risk to children in care.
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In addition, Per Principal she will have an all staff training on care and supervision and will submit training agenda/sign in sheet via email to LPA Garcia no later than 10/14/2022.

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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:Mireya Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2022


LIC809 (FAS) - (06/04)
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