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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414037
Report Date: 12/04/2024
Date Signed: 12/04/2024 03:46:38 PM

Document Has Been Signed on 12/04/2024 03:46 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CCRC HEAD START - RESEDAFACILITY NUMBER:
197414037
ADMINISTRATOR/
DIRECTOR:		ARACELI GROSSMANFACILITY TYPE:
850
ADDRESS:18120 SATICOY STREETTELEPHONE:
(818) 705-0113
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 58TOTAL ENROLLED CHILDREN: 46CENSUS: 33DATE:
12/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:33 AM
MET WITH:Director Eliabeth FloresTIME VISIT/
INSPECTION COMPLETED:
03:57 PM
NARRATIVE
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On 12/4/24, Licensing Program Analyst (LPA) Jeanine Lipsey conducted an unannounced, Case management incident inspection. The incident was reported to Community Care Licensing on 12/02/24 via phone. The incident which occurred on 12/02/24, which was that a child was left in the bathroom unattended.

Upon arrival, LPA was guided on a tour of the facility by Teacher Sy Hearn, to whom the purpose of the inspection was announced.

Census: There were thirty-three children being supervised by thirteen staff.

During the inspection, LPA obtained a copy of the Child Care Facility Roster, Employee roster, wriiten statement from staff “Care and Supervision” Policy, weekly “Supervisor Check Off List” and conducted interviews with 3 staff, 1 child, 1 parent and took measurements of how far of the bathroom was to the classroom.



On 12/2/24 There were a total of fifteen children in the classroom with three staff. At around 12:20pm-12:24 pm, three children in Room 1 were taken to the restroom by Staff #2 S2. They were transitioning from lunch time to nap time and needed to use the restroom. The restroom was measured to be, 54 feet from the classroom with a clear view from the classroom.

Child #1 was using the restroom and was accidentally left in the restroom by S2. Per Child #1, they did not know how long they were alone in the restroom, but they were not scared but worried and did not cry. When C1 completed using the restroom, they proceeded to walk back to class. Staff #1 (S1) was coming from the office, which is across the yard, and noticed C1 coming from the restroom alone, and asked where the teacher was.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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Document Has Been Signed on 12/04/2024 03:46 PM - It Cannot Be Edited


Created By: Jeanine Lipsey On 12/04/2024 at 01:19 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CCRC HEAD START - RESEDA
FACILITY NUMBER: 197414037

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2024
Section Cited
CCR
101229(a)(1)

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RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION

No child(ren) shall be left without the supervision of a teacher at any time...

This requirement is not met as evidenced by:
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The staff responsible will receive a formal written notice which includes a webinar on care and supervision, coaching, and weekly check ins.. The director will send proof of completion via email by Jan 10th.
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Based on interview and investigation, C1 was left alone in the restroom unsupervised, which posed a potential Health or Safety, or personal rights risk to persons in care.
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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:Betty Bell
LICENSING EVALUATOR NAME:Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2024


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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CCRC HEAD START - RESEDA
FACILITY NUMBER: 197414037
VISIT DATE: 12/04/2024
NARRATIVE
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They both proceeded to the classroom and was met by Staff #2(S2), the one responsible for leaving the child. S2 disclosed they were preoccupied with a telephone call from the hospital and forgot they had a 4th child in the restroom since they originally only took 3 children and was given a 4th child later once in the restroom. All staff interviewed stated the child was left for less than a minute, because it only takes about thirty seconds to walk back to the classroom from the restroom. As soon as S2 returned to class, Staff #3 asked where was C1. As S2 opened the door to go back to retrieve the child is when both C1 and S1 were coming back to the class. Parent #1 (P1) stated they were told what happed at pick up and was explained the supervision policy in place. P1 stated the child did not mention the incident and P1 was not worried due to the location of the restroom and how the child is not fearful child. P1 stated they do not have any complaints regarding the incident. They are satisfied with the service they receive and do not want anything to happen to the staff involved.

Per the facilities, “Care and Supervision Policy, at all times, all children must be directly supervised by sight and sound while under the care of staff, including transitions and toileting”. They also stress “While actively engaged with children, staff should not use cell phones”. The director stated they have a zero policy for lack of supervision and the staff responsible will receive a formal written notice which includes a webinar on care and supervision, coaching, and weekly check ins.

The department finds there was a deficiency in compliance. A citation will be issued.

Exit interview conducted and report was reviewed with Director Elizabeth Flores.  A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC809 (FAS) - (06/04)
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