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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419928
Report Date: 11/10/2021
Date Signed: 11/10/2021 01:53:34 PM

Document Has Been Signed on 11/10/2021 01:53 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:YOUNG MINDS PRESCHOOLFACILITY NUMBER:
197419928
ADMINISTRATOR:NYAH DORGANFACILITY TYPE:
850
ADDRESS:3030 WESTWOOD BLVDTELEPHONE:
(424) 832-3711
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY: 106TOTAL ENROLLED CHILDREN: 106CENSUS: 92DATE:
11/10/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Jennifer Kerkes, Licensee and Hannah Weinstock, Director AssistantTIME COMPLETED:
02:05 PM
NARRATIVE
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On 11/10/2021 at 11:20 am, Licensing Program Analyst (LPA) Denise Miranda conducted an unannounced case management inspection at Young Minds located at 3030 Westwood Blvd, Los Angeles, CA 90034 for the purpose of following up on the unusual incident that was self-reported by the facility. The El Segundo Child Care Regional Office received the report on 11/02/2021. LPA met with Licensee Jennifer Kerkes and Director Assistant.

According to the incident report, on 10/27/2021, child#1 was playing at 2s yard, while playing, child#1 jumping off a slide while landing, it appeared to the teachers#1,#2 and #3 as if child#1 twisted his ankle. Child#1 did not cry, however child showed signs of discomfort. Teachers#1,#2 and #3 provided immediately assistance to the child#1 and contacted the mother of the child to pick up for early day.

During this inspection, LPA Miranda, conducted an inspection at the outdoor space 2s yard and observed that the cedarworks slide equipment structure it was removed from this area. Per Director Assistant the equipment was removed next day of the incident on 10/28/2021, and no child has access to this equipment. LPA observed that equipment structure was placed on off-limit (storage room). LPA observed that the surface of the 2s yard it is cover with synthetic grass. Per Director Assistant, under the synthetic grass it is cover with hard sand.

Director Assistant and Licensee, provided a copy of invoice stated that a new pad will be install tomorrow (11/11/2021), facility will be closed due a holiday and no children will be present. A declaration was obtained from Licensee.
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: YOUNG MINDS PRESCHOOL
FACILITY NUMBER: 197419928
VISIT DATE: 11/10/2021
NARRATIVE
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Per Licensee's declarion no equipment structure will be install at the 2s yard or anywhere else in the preschool. If plan to make nay changes to the yard or preschool, facility will report it to CCLD in 24 hours over the phone and submit a lic624 Unusual Incident Report form no later than 7 days.

Also, LPA observed at the upper yard outdoor space, a hole needs to be cover and a label for equipment structure for age appropriate needs to be placed. Licensee place cones to make this area inaccessible to the children.

Based on the available information, it appears that the incident was the result of a Title 22 violation for Outdoor Activity Space. Facility was cited a Type B violation today, 11/04/2021 (See LIC 809-D for deficiency cited.)

An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit were provided to Jennifer Kerkes, Licensee.
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/10/2021 01:53 PM - It Cannot Be Edited


Created By: Denise Miranda On 11/10/2021 at 01:02 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: YOUNG MINDS PRESCHOOL
FACILITY NUMBER: 197419928

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/17/2021
Section Cited
CCR
1012382.(e)

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e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.
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Facility removed the cedarworks slide equipment from the 2s yard to a off-limit area (storage). A declaration was obtained during this inspection, stated that facility will not install any equipment structure
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This requirement is not met by evidences: During inspection, LPA observed that 2s Yard has synthetic grass with hard surface. This poses a potential H&S to children in care.
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without report to CCLD and granted an approval. A copy of an invoice it was provided to LPA new padding will be install at 2s yard. Facility will provide photos via email to LPA no later than 11/17/2021.

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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:Peter Flores
LICENSING EVALUATOR NAME:Denise Miranda
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2021


LIC809 (FAS) - (06/04)
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