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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003398
Report Date: 09/26/2024
Date Signed: 09/26/2024 04:10:19 PM

Document Has Been Signed on 09/26/2024 04:10 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CHILD EDUCATIONAL CENTER, CALTECH/JPL COMMUNITYFACILITY NUMBER:
198003398
ADMINISTRATOR/
DIRECTOR:
CHRISTY WATERMANFACILITY TYPE:
840
ADDRESS:471 KNIGHT WAYTELEPHONE:
(818) 790-2347
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY: 125TOTAL ENROLLED CHILDREN: 125CENSUS: 52DATE:
09/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:22 PM
MET WITH:Chelsea PeatetskyTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 09/26/24 , at 2:20 PM ,Licensing Program Analysts (LPA) Shushanik Safaryan conducted an unannounced Case Management inspection for the purpose for the following up on an unusual incident report received by the Department . Upon arrival, LPA met with Site Coordinator Director, Chelsea Peatetsky, to whom the reason was explained .Tour of the facility was provided. There were children present during the inspection.

Census was taken. There were 52 children and 7 staff members.

On 09/12/24, an unusual incident report was submitted to the Department regarding a child sustaining an injury on the facility grounds. Child was playing on the monkey bars at the playground structure , when she missed the bar and fell . Child was seen by the doctor ,broken elbow confirmed, and full arm cast was placed.

During the inspection , LPA observed the area where the incident took place. Obtained pictures of monkey bar , band aid report , interviewed staff members and children .

Based on the information obtained ,LPA determined that incident needs further investigation .

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview conducted with the Site Director and Copy of Report provided.

END OF REPORT

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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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