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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494348
Report Date: 12/16/2024
Date Signed: 12/17/2024 09:16:46 AM

Document Has Been Signed on 12/17/2024 09:16 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BRELLA PLAYA VISTA PRESCHOOLFACILITY NUMBER:
197494348
ADMINISTRATOR/
DIRECTOR:		KIMBERLY KERNFACILITY TYPE:
850
ADDRESS:12746 W. JEFFERSON BL. #3-3100TELEPHONE:
(213) 300-5962
CITY:LOS ANGELESSTATE: CAZIP CODE:
90094
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 42DATE:
12/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:01 PM
MET WITH:Kimberly KernTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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On 12/16/2024, Licensing Program Analysts (LPA) Ranita Richmond and Brittany Lovest conducted an unannounced Case Management-Incident visit for the above-named Child Care Center. Center is licensed for 56 preschool children, ages 2 years through entry into first grade. LPAs met with Director Kimberly Kern. LPAs Richmond and Lovest toured the facility indoors and outdoors and observed 42 children in care, being supervised and cared for appropriately by 7 fingerprint cleared staff members. Facility hours of operation are Monday – Friday, 8:00am – 5:00pm.

Facility has an approved outdoor waiver and LPAs observed waiver posted in the front lobby.


Waiver includes the following: There shall be no more than 9 children in the outdoor garden area at the same time. Room 3, (Art Lab) will be used in conjunction with the outdoor garden with a capacity of no more than 11 children. There shall be no more than 16 children in the Indoor Gross Motor room at the same time. No preschool children shall be without direct visual supervision by qualified staff at any time.

Facility contacted the On Duty (OD) Analyst on 12/13/2024 to report an unusual incident that occurred at the facility on 12/12/2024. Unusual incident report verbally submitted to the El Segundo Child Care Regional Office states that while playing at 3:45 PM child was running in the garden with a wooden toy mallet. Child slipped and fell and began to cry for about 30 seconds. Child’s eye began to swell immediately. Ice was applied to child’s eye and while applying ice noticed child had a change in behavior, was not responding to questions, eyes were rolling back and had shallow breathing. Director called child's guardian (foster great aunt- Phembia Dennis) and confirmed child’s symptoms with guardian and that 911 was being called. Ambulance arrived at approx. 3:50 PM and child was taken to hospital by ambulance due to child’s symptoms.

During today's visit, director confirmed that on the date of incident, 1 staff member was outside in the garden area providing care and supervision to 5 children.

During today’s inspection, LPA observed the outdoor garden space, the equipment that children were using during the incident and the placement of the teacher in the yard. LPA interviewed staff named in the incident report, director, and children present on date of incident.
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SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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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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: BRELLA PLAYA VISTA PRESCHOOL
FACILITY NUMBER: 197494348
VISIT DATE: 12/16/2024
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Child injured in UIR report is not present at school today.

Further investigation is necessary.

Per Title 22 Regulations and Health and Safety Codes, no citations were issued.

An exit interview was conducted, a copy of this report was read and provided to Director Kimberly Kern.

Notice of Site Visit was provided and required to be posted for 30 days.

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SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
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