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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011689
Report Date: 09/19/2024
Date Signed: 09/19/2024 01:14:21 PM

Document Has Been Signed on 09/19/2024 01:14 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:ST. ANNE'S EARLY LEARNING CENTERFACILITY NUMBER:
198011689
ADMINISTRATOR/
DIRECTOR:		MARIA ELENA MEDINAFACILITY TYPE:
830
ADDRESS:151 N. OCCIDENTAL BLVD.TELEPHONE:
(213) 381-2931
CITY:LOS ANGELESSTATE: CAZIP CODE:
90026
CAPACITY: 63TOTAL ENROLLED CHILDREN: 57CENSUS: 41DATE:
09/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Golnaz, Koklanfar-Coach Coordinator and Eloisa Lopez Gonzalez, Lead teacher.TIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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On September 19, 2024, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced case management inspection to follow up with an incident that was reported to the department. LPA met with Golnaz, Koklanfar-Coach Coordinator and Eloisa Lopez gonzalez, Lead teacher, who guided LPA on a tour of the facility.

On 9/12/2024, it was reported to the department that on 9/11/24 C#1 attempted to get toy puppets from the floor near the corner of the activity table when C#1 lost balance as C#1 was coming up causing. C#1 to hit the corner of the activity table on forehead causing an open wound. C#1 was taken to seek emergency medical treatment and received treatment for the wound. S#1 stated that the incident was observed, and S#1 was within arm’s reach of the child. The incident happened so fast it was unable to be prevented. The incident was reported to the Department within the 24-hour period and the written report was received via email on 9/12/2024.

During today’s inspection, interviews were conducted, and documentation was reviewed and obtained. C#1 incident on 9/11/24 was observed and first aid was provided. C#1 was released to return back to school. Per P#1, C#1 will remain home a little longer until wound scabs. Though the hit did break the skin, no regulations were violated. This was an accident. Based on information obtained from S#1, S#2 and P#1, there were no corroborating information to determine that there was a lack of supervision during the incident nor a violation of a child’s personal rights. LPA did advise, Golnaz, Koklanfar best practice to add cushion boarders around tables in all Early Head Start classrooms where young children ages 0-3 are cared for. Per, Golnaz, Koklanfar-Coach Coordinator cushioned borders will be added to all Early Head Start classrooms.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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

Exit interview conducted and report was reviewed with the facility representatives Golnaz, Koklanfar-Coach Coordinator and Eloisa Lopez gonzalez, Lead teacher.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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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