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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402062
Report Date: 11/07/2024
Date Signed: 11/07/2024 03:13:59 PM

Document Has Been Signed on 11/07/2024 03:13 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:WILTON PLACE EARLY EDUCATION CENTERFACILITY NUMBER:
197402062
ADMINISTRATOR/
DIRECTOR:		RICKY LIMFACILITY TYPE:
850
ADDRESS:4030 LEEWARD AVENUETELEPHONE:
(213) 383-4971
CITY:LOS ANGELESSTATE: CAZIP CODE:
90005
CAPACITY: 110TOTAL ENROLLED CHILDREN: 81CENSUS: 65DATE:
11/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Ricky Lim, PrincipalTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced Case Management inspection due to an incident that was reported to the Department on 9/18/2024. LPA met with Principal Ricky Lim who guided LPA on a tour of the facility. Census was taken.

On September 18th, 2024, an incident was self reported to the Department via Email by the facility who reported that Child #1 (C1) was injured due to them slipping while climbing down the playground apparatus.



All reports were reported within the required 24 hours. The purpose of the inspection was to obtain additional information regarding the incidents reported to the Department.

During the inspection, LPA Valenzuela conducted interviews with three staff. LPA was unable to conduct interview with C1, as C1 no longer attends the school. Staff #3 (S3) disclosed that they observed C1 fall from the apparatus and C1 landed on their hands first, which resulted in C1 left pinky finger swelling. S3 stated that they took C1 to the nurse's offices and an ice pack was provided to C1. According to the Principal, nurse recommended that C1 be seen by a doctor, due to the finger swelling. Per Principal, they notified parent that C1 should be seen by a doctor. Principal stated that C1 returned to school and staff assessed C1's finger and that the swelling was reduced. Per Principal and S3, they disclosed that parent did not take C1 to the doctor, because C1's swelling was reduced by the time they got to their home. Regarding the incident no disclosures were made on this date regarding personal rights violations. LPA asked for copies of Notice of First Aid, and Office Referral.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: WILTON PLACE EARLY EDUCATION CENTER
FACILITY NUMBER: 197402062
VISIT DATE: 11/07/2024
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At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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 Principal Ricky Lim.



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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC809 (FAS) - (06/04)
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