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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006258
Report Date: 05/07/2024
Date Signed: 05/07/2024 11:23:25 AM

Document Has Been Signed on 05/07/2024 11:23 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:BELMONT SHORE CHILDREN'S CENTERFACILITY NUMBER:
198006258
ADMINISTRATOR/
DIRECTOR:
ANNA MARTINEZFACILITY TYPE:
850
ADDRESS:30 S. TERMINOTELEPHONE:
(562) 439-3369
CITY:LONG BEACHSTATE: CAZIP CODE:
90803
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: DATE:
05/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Director Anna MartinezTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On May 7, 2024 at 9:30 am, Licensing Program Analysts (LPAs) Angelica Wallin and Alicia Mooberry conducted a Case Management Incident inspection. This inspection is regarding an incident that took place on February 28, 2024 in which a child, in the T-K room, while running in the sandbox tripped, fell on a plastic Little Tike’s chair and sustained a small open wound cut on her left eyelid. LPA met with director, Anna Martinez, who provided information and assistance during the inspection. A census of 28 was taken. LPAs observed 11 children with one teacher in the T-K room.

During the course of the inspection, LPAs conducted interviews with two children and one staff. During inspection, LPAs reviewed staff and children’s records. LPAs evaluated outdoor play area where incident occurred and plastic Little Tike’s chair. LPAs observed age-appropriate playground area and toys for children in care.Per director, child fell and hit her head on top of the backrest of the chair. LPAs observed dried blood remains on plastic Little Tike’s chair. Per director, plastic Little Tike’s chair will be cleaned and placed back in the sandbox. Per children and staff interviews, it was confirmed that child was playing by running in the sandbox, took a misstep and fell. Per staff interview, plastic Little Tike’s chair that is typically kept inside the doll house play structure was moved by another child to another area in the sandbox between brick wall and another plastic play structure. Per staff interview, teacher was standing on left side of the sandbox under the shade and had complete supervision of children playing in the sandbox. LPAs observed outdoor play area is enclosed and all playground structures in the sandbox are equally spaced with accessible walkways for children to play in the sandbox.

Based on the available information: observations, interviews with children and staff and record review, no Title 22 deficiencies cited. LPAs discussed with director, preventative measures to be implemented during outdoor play. Per director, there is a no running policy to prevent trips and falls. Per director, children are reminded daily during outdoor play regarding rules of outdoor play. LPAs inquired regarding use of plastic Little Tike’s chair in the playground. Per director, plastic Little Tike’s chair will be removed to further prevent any trips or falls.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE: DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2024
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: BELMONT SHORE CHILDREN'S CENTER
FACILITY NUMBER: 198006258
VISIT DATE: 05/07/2024
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The content of this report was read and discussed in detail at the time of inspection with director, Anna Martinez. An exit interview was conducted, a notice of site visit to be posted for 30 days provided.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024
LIC809 (FAS) - (06/04)
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