<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017704
Report Date: 11/19/2024
Date Signed: 11/19/2024 02:50:53 PM

Document Has Been Signed on 11/19/2024 02:50 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:CESAR CHAVEZ HEAD STARTFACILITY NUMBER:
198017704
ADMINISTRATOR/
DIRECTOR:
DOLORES TREVINO & JULIE SAFACILITY TYPE:
850
ADDRESS:730 W. 3RD STREET AVENUETELEPHONE:
(562) 491-7536
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 20DATE:
11/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Head Teacher- Katheryn Morgan TIME VISIT/
INSPECTION COMPLETED:
03:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Jeanette Estrada and Jonnisha Culbert conducted a case management visit for the purpose of following up on an incident reported to the Department. LPAs initially met with Instructional Aide Gladys Leyva and Head Teacher Katheryn Morgan. Early Learning Center Managers, Monica Alvarado and Keokuk Legarde joined at a later time. LPAs advised facility representatives of the purpose of the visit.

The facility submitted an unusual incident Report (UIR) to the Department on 11/13/24. The incident occurred on the same day 11/13/24. Per the report submitted Child 1 was using the climber during outside time and lost their footing resulting in them falling off the climber and hitting their head. The UIR also reported that the child had suffered a concussion.

During today's visit, LPAs conducted staff interviews, made observations of the climbing structure and reviewed pertinent documents. Per staff interviews, Child 1 was coming down the stairs of the climbing structure, slipped off one of the stairs and fell backwards hitting the back of their head. Per Staff interviews, there were two staff and 13 children outside. One staff was supervising the climbing structure area but was engaging with another child when the incident occurred. Per Staff 1, after Child 1 fell, they went over to Staff 1 for assistance. Staff 1 provided Child 1 with an ice pack which Staff 1 ensured the child kept on while they waited for their parent to pick them up. Parent picked up child and Child was taken to the doctor at a later time. Per Staff, the child provided a Doctor's note when they returned on 11/19/24. Per documents provided, child was cleared to return on 11/14/24 and there were no restrictions.

Per Staff, they are working with children on reminding them to hold onto the rails as they are climbing on the structure and they are working with parents on advising them that children should wear non-slip shoes.
Based on interviews conducted, no deficiencies are being issued today.
Exit interview was conducted with Monica Alvarado and Keokuk Legarde Early Learning Center Managers. A copy of the report and the Notice of Site Visit was provided.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1