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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890370
Report Date: 09/05/2024
Date Signed: 09/05/2024 02:55:54 PM

Document Has Been Signed on 09/05/2024 02:55 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:JARDIN DE NINOS CHILD CARE CENTERFACILITY NUMBER:
191890370
ADMINISTRATOR/
DIRECTOR:		ALICIA LOMELIFACILITY TYPE:
850
ADDRESS:2422 MANITOU AVETELEPHONE:
(323) 223-1230
CITY:LOS ANGELESSTATE: CAZIP CODE:
90031
CAPACITY: 46TOTAL ENROLLED CHILDREN: 39CENSUS: 34DATE:
09/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:01 PM
MET WITH:Assistant Site Supervisor, Maria Garcia TIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced Case Management inspection due to an incident that was reported to the Department. LPA met with Assistant Site Supervisor Maria Garcia who guided LPA on a tour of the facility. Census was taken.

On June 14 2024, an incident was self reported to the Department via phone by the facility who reported child #1 and staff #1 stepped wrong and fell to the floor while staff #1 was still holding the child #1 causing child #1 to bump head. Report was reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incident reported to the Department. During the inspection, LPA Perry conducted interviews with staff, obtained declarations from staff and took pictures of the area.



Regarding incident that occurred on June 14th, 2024, interviews were conducted, incident was observed by staff and first aid was provided. LPA observed the area and took pictures where incident happened and also obtained incident report. Staff were interviewed- Both staff disclosed that parents were notified and incident report was provided child was not taken to the doctor and was back the next day with no restrictions or concerns. Based on information obtained, no additional follow up is necessary regarding the incident reported. The facility followed proper procedures; staff administered first aid and child’s parents were notified. At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies are being cited at this time.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Assistant Site Supervisor, Maria Garcia
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
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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