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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494300
Report Date: 12/04/2024
Date Signed: 12/04/2024 02:26:44 PM

Document Has Been Signed on 12/04/2024 02:26 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CRYSTAL STAIRS HEAD START - LITTLE STARSFACILITY NUMBER:
197494300
ADMINISTRATOR/
DIRECTOR:		LAURA CARDENASFACILITY TYPE:
850
ADDRESS:2720 W SLAUSON AVETELEPHONE:
(323) 421-2662
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 16DATE:
12/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Norma Izucar, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
NARRATIVE
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On 12/4/2024, Licensing Program Analyst (LPA) Loyce Phillips, conducted a case management inspection to follow up on an Unusual Incident, reported to the department by email on 11/6/2024. LPA was greeted by Lead Teacher, Alicia Parker. LPA toured the facility and took a census of the children. LPA observed 16 children in care with 3 staff members. Norma Izucar, Site Supervisor joined the visit at 12:15pm.

Description of the incident: On 11/5/2024, approximately 10:25am Child 1 (C1) was running in the classroom and ran into another child. The child fell backwards and started crying. Staff went over to C1 and noticed child was holding his left arm. Staff comforted the C1 and applied an ice pack to his left arm. Parent was called at 10:45am. Parent picked up C1 at 12:00pm and took child to the doctor. Parent reported back to the facility that C1 had gotten an x-ray and sustained a broken wrist. C1 returned to the facility on 11/7/2024 with restrictions. Doctors note on file.

Based on the information obtained, interviews conducted and observations of the classroom environment.

C1 accidentally ran into another child while playing with a folded soft chair. Child fell and sustain a broken arm. Staff in the classroom failed to take the folding chair in a timely manner prior to child falling, therefore a deficiency is cited.

A notice of site visit was given and posted for 30 days.



Exit interview conducted and report was reviewed with Site Supervisor, Norma Izucar.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
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 02:26 PM - It Cannot Be Edited


Created By: Loyce Phillips On 12/04/2024 at 01:00 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: CRYSTAL STAIRS HEAD START - LITTLE STARS
FACILITY NUMBER: 197494300

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2024
Section Cited
CCR
101223(a)(2)

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101223(a)(2)(a)Personal Rights The licensee shall ensure that each child is accorded the following personal rights (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Site Supervisor has removed the soft folded chairs into the staff restroom, inaccessible to children in care. Site Supervisor will meet with staff to discuss childrens personal rights and classroom environment safety and send a summary to LPA by POC date.
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Based on interview statement from S1, C1 was playing with a soft folded chair when another child pushed him and child fell. S1 failed to remove the chair from C1 in a timely manner causing child to fall on the chair which posed a potential health, 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:Karren Starks
LICENSING EVALUATOR NAME:Loyce Phillips
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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