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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494241
Report Date: 08/28/2025
Date Signed: 08/28/2025 04:16:31 PM

Document Has Been Signed on 08/28/2025 04:16 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 - ALOHA LEARNING CENTERFACILITY NUMBER:
197494241
ADMINISTRATOR/
DIRECTOR:		NUBIA JUAREZFACILITY TYPE:
850
ADDRESS:13000 VAN NESS AVENUETELEPHONE:
(424) 340-2640
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY: 92TOTAL ENROLLED CHILDREN: 90CENSUS: 51DATE:
08/28/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:26 PM
MET WITH: Nubia Juarez- Regional Site DirectorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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 On 08/28/2025 Licensing Program Analyst( LPA) Doris Whitmore conducted a case management inspection to follow up on an Unusual Incident reported to the department by telephone on 08/22/2025. LPA Whitmore met with Nubia Juarez, Regional Site Director and toured the facility. LPA Whitmore observed 51 children and 15 staff.
According to the Unusual Incident report, Child was playing in classroom in the house keeping area and tangled her feet walking around and fell. She hit the top of her left side of face above the eyebrow. States there was no bleeding. An icepack was applied bruise. There was no open wound but swelling. The parents were notified and took child to clinic.
LPA Whitmore interviewed two staff and one child.
(S1): At the time of the incident, I was in the block area with other students, I heard a bang and I looked up and my Teacher Assistant was holding (C1). She was crying and said something along the lines she hit her head it is bad. I went over and looked, and I could already see a bruise mark on her forehead. I grabbed an ice pack and held (C1) and put the ice pack where the injury was. I asked my Teacher Assistant, to call over the radio for support. Our Site Lead Yvette stepped into the classroom, and my Teachers Assistant left to go and notify the parent. I held the ice pack on (C1) head for 5 to 7 minutes. She stopped crying. I took the ice pack out and then we went about playing during choice time. I continued to monitor her until her mother arrived.

( S2) We were at choice time; we had come from outside. It was 4:03p.m. It was me and two other peers. We were playing this game with owls and colors. Peer was playing counting and saying colors. (C1) was going by and seen that we were playing. I gave (C1) the stick with the owls. The peer was on one side of the table and (C1) was on the other side.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Doris Whitmore
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2025
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: PACE - ALOHA LEARNING CENTER
FACILITY NUMBER: 197494241
VISIT DATE: 08/28/2025
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(C1) went around the table. She did not trip over the table. It was more like the floor. (C1) tripped in the middle and hit her left side on the eyebrow. When I saw that she hurt herself. I picked her up and she started crying. That’s when I told (S1) she was at the table by the block area. (S1) held (C1) while I went to go get the ice pack. I called for support for someone to come in. I did the Ouchy report and the head injury report. I called the mom, and mom did not pick up. I called dad and told him what happened. From there, I told Nubia that I was going to call it in. I called the front desk (PACE). I went back to the classroom. I gave mom the report and the head injury report. Also, that if mom was going to take her to the doctor.

(First Aid was administered by (S1). (S2) notified the parent of (C1). (S2) wrote the incident report and gave mom the original and the copy of the head injury form. Mom could not get an appointment with the doctor. (C1) was cleared by the internal nurse of the Agency.

(S2) was able to show LPA Whitmore the location in the classroom where the incident took place. S1 pointed out the table where (C1) went around. (S2) was able to show LPA Whitmore with her shoe where (C1) fell and where she landed when she hit her head. The table and the kitchenette set are in the same area in the housekeeping area. There is no carpet in the area.

LPA Whitmore was able to obtained a picture of (C1) forehead, incident report, and head injury form.

LPA concluded this case management incident visit. No Title 22 violations have occurred, and no deficiencies cited. Exit interview conducted and report was reviewed with Nubia Juarez, Regional Site Director. A notice of site visit was given and posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Doris Whitmore
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC809 (FAS) - (06/04)
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