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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197404132
Report Date: 11/05/2024
Date Signed: 11/05/2024 12:12:31 PM

Document Has Been Signed on 11/05/2024 12:12 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PACE - WEST BOULEVARDFACILITY NUMBER:
197404132
ADMINISTRATOR/
DIRECTOR:		SILVA DE LA ROSAFACILITY TYPE:
850
ADDRESS:1809 WEST BLVD.TELEPHONE:
(323) 954-8099
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY: 68TOTAL ENROLLED CHILDREN: 68CENSUS: 44DATE:
11/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:32 AM
MET WITH: Lashaye Davis- Regional Site DirectorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 11/5/2024 at 8:32 a.m. Licensing Program Analyst (LPA)Doris Whitmore conducted an follow up unannounced visit for conducting a Case Management Inspection due to an incident that occurred on 09/19/2024 and was reported to the Regional Office. LPA met with Lashaye Davis, Regional Site Director and informed the nature of the visit. LPA observed 44 Children in care with proper teacher/child ratios observed. There was a total of 6 staff.
LPA Whitmore continued with Interviews of one teacher and one child. C3 was absent from school today. The Regional Site Director called mom to ask for permission to interview C3 on the phone. Mom was at the doctor's office. Regional Site Director Lashaye Davis gave LPA Whitmore mom's phone number. LPA Whitmore called the mom to interview. LPA Whitmore asked the mom if the interview could be at the home. Mom responded and said yes. A collateral visit was done to interview C3:After conducting Interviews and reviewing documentation that was obtained on 10/16/2024. S1 ran to prevent the child from throwing the ladle but it was to late. First Aid was administered C1 was bleeding and pressure was applied. C1 had a gash cut on his forehead. At the time of the incident S 2 had taken some children to the restroom. Staff Notified Mother of C1. Mother came and took C1 to the doctor. Child returned to the school with no restrictions. . On 10/16/2024 LPA Whitmore was able to vertify the date of return for C1. LPA Whitmore spoke to the School Nurse Parnay. Other staff stepped in so the other children in the class would be care for.
Based on interviews and documentation obtained there was no lapse of Care and Supervision. There are no violations of Title 22 Regulations, no deficiencies cited. An exit inter view was conducted with Regional Site Director Lashaye Davis. A copy of report, Notice of Site Visit, & Appeal Rights were issued.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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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