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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492952
Report Date: 08/27/2025
Date Signed: 08/27/2025 11:10:53 AM

Document Has Been Signed on 08/27/2025 11:10 AM - 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:COALICION DE LATINOS AMERICANOS, INC.FACILITY NUMBER:
197492952
ADMINISTRATOR/
DIRECTOR:		RUIZ, FABIOLAFACILITY TYPE:
850
ADDRESS:3130 W. 139TH STREETTELEPHONE:
(562) 279-6330
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 40TOTAL ENROLLED CHILDREN: 31CENSUS: 14DATE:
08/27/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:06 AM
MET WITH: Cynthia Navarro- Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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 On 08/27/2025 Licensing Program Analyst ( LPA) Doris Whitmore , conducted a case management to follow up on an Unusual Incident, reported to the department by telephone on 04/16/2025. LPA met with Site Supervisor. Cynthia Navarro and toured the facility. LPA observed 14 children and 3 teachers.
According to the Unusual Incident On April 16, 2025 ( S2) was in the block area inside the classroom with (C1), when another child names( C2) was crawling towards ( C1). ( S2) looked away when she looked back( C1) lip was bleeding. I ( S1) walked in the classroom and offered ( C1) an ice pack to put on his lip. ( S2) then explained to me what happened. Mother was notified of the incident over the phone at 9:33a.m. and during departure time at 10:56 a.m.. ( S1) spoke to the mother and showed her ( C1) bottom lip in person during pick up time.( C1) was pointing to his lip and saying ( C2) ( C2).

LPA Whitmore interviewed two children and the Site Supervisor. During the interview ( C1) did not respond to some of the questions and could not tell LPA Whitmore what happened. ( C2) also, did not respond to LPA Whitmore questions and could not state what happened to ( C1) when he was crawling towards ( C1). During the Site Supervisor interview. ( S2) the day of the incident informed( S1) what happened? ( S1) stated that there were two teachers in the block area and that she did not see the incident. ( S2) was in the block area with (C1) and ( C2) when she turned her head ( C1) was bleeding and ( C1) was pointing at ( C2).( S1) grabbed an icepack and ( C1) was just pointing.(S1) notified both parents. An ouch report was given to the parent.( C1) did not Page 1
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Doris Whitmore
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: COALICION DE LATINOS AMERICANOS, INC.
FACILITY NUMBER: 197492952
VISIT DATE: 08/27/2025
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go to the doctor. The mother of ( C1) stated that she will keep an eye on him. Both children are 4 years old. The incident occurred in the morning. ( C1) returned back to school after Spring Break.
During the visit, LPA Whitmore obtained a copy of the Ouch report.

LPA concluded this case management incident visit. No Title 22 violations have occurred, and no deficiencies cited. An Exit interview conducted and report was reviewed and read with Site Supervisor Cynthia Navarro, A notice of site visit was given and must be posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Doris Whitmore
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC809 (FAS) - (06/04)
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