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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700391
Report Date: 01/29/2025
Date Signed: 01/29/2025 12:28:22 PM

Document Has Been Signed on 01/29/2025 12:28 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PADILLA FAMILY CHILD CAREFACILITY NUMBER:
195700391
ADMINISTRATOR/
DIRECTOR:		MIRIAN PADILLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 424-4472
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/29/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Licensee Mirian PadillaTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 1/29/2025, Licensing Program Analyst (LPA) Amelia Morales conducted an unannounced case management inspection due to an incident which occurred on 1/23/2025. The incident was reported via phone on 1/28/2025 and written report was submitted to CCL (in person) on 1/28/25. LPA arrived at the home and met with Licensee Mirian Padilla, who guided LPA on a tour of the home. There were 9 children and 1 staff member present at the time of the visit.

Incident: Child #1 chipped their tooth going head first down a slide.
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Child #1 was present during the visit, LPA Morales observed Child #1 sit on top of chair and tried to climb the table, in two occurrences.

During staff interview LPA was informed that Staff #1 had active supervision of the child who obtained an injury. Staff #1 stated they were outside pushing another child in a cart when the injury occurred. Staff #1 informed LPA that prior to Child #1 going head first down the slide, Staff #1 warned the Child #1 not to do so. Staff #1 explained that they checked on the Child #1 and asked if the Child #1was "okay." Staff #1 stated that the Child #1 replied they were "okay." The Child #1 did not show any signs of discomfort and went back to playing.

Based on interviews conducted and observations made by LPA

During the inspection, LPA obtained a copy of the child care facility roster, and conducted interviews with Licensee, staff #1, took photos and made observations of the play structure where the incident occurred. Based on all information obtained on this date, and interviews conducted with staff, the incident appears to be an unusual incident. There were no deficiencies observed in regards to todays visit.

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

An exit interview was conducted with the Licensee Mirian Padilla and a copy of this report was provided along with the Appeals Rights.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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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