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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017685
Report Date: 05/10/2024
Date Signed: 05/10/2024 04:12:50 PM

Document Has Been Signed on 05/10/2024 04:12 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CALIFORNIA HOSPITAL MEDICAL CENTER-EARLY EDUCATIONFACILITY NUMBER:
198017685
ADMINISTRATOR/
DIRECTOR:
SYLVIA AGUILARFACILITY TYPE:
850
ADDRESS:1600 S. HOPE STREETTELEPHONE:
(213) 742-6385
CITY:LOS ANGELESSTATE: CAZIP CODE:
90015
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 26DATE:
05/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Veronica MedranoTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 5/10/24 at 9:30AM Licensing Program Analysts (LPA) Claudia Kam conducted an Unannounced Case management Inspection to follow up on an incident that was reported to the Department on 4/22/24. Upon arrival, LPAs announced purpose of inspection and met with Facility Representative Veronica Medrano, who granted entry to facility and provided a tour of the playground. Census was taken.

On 4/22/24, an incident was reported to The Department where a child sustained an injury while in care. The facility reported this incident to the Department within the required 24 hours and submitted written report within seven days.

During this inspection LPAs interviewed staff, observed child who was injured and observed the play structure and play area where the incident took place. Teacher informed Licensing that child was standing on the cushioned play structure material and attempted to run and tripped upon trying to run falling on is arm. Teacher has stated that she observed the incident and upon observing that child was holding his arm after falling, took him to the classroom to observe the injury. Child continued to hold his arm so teacher took the child to the nurse who applied first aid and called parent immediately. Child returned the day after the incident with a cast and was observed at time of visit to be playing unhindered. Teacher states that after child continues to play and participate in all daily activities without assistance for his injury. The play surface where the incident took place was observed to be well maintained and had proper cushioning therefore no changes were taken or needed regarding prevention by the facility. Based on the information obtained and LPAs observation LPAs determined there was adequate supervision and Facility Representatives and no adjustments are needed.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.
A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Facility Representative Veronica Medrano.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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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