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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019549
Report Date: 05/31/2023
Date Signed: 05/31/2023 03:33:57 PM

Document Has Been Signed on 05/31/2023 03:33 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LBUSD-DOOLEY CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198019549
ADMINISTRATOR:NANCY PEREZFACILITY TYPE:
850
ADDRESS:5075 LONG BEACH BLVDTELEPHONE:
(562) 428-6369
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 14DATE:
05/31/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Ines Leighton, TeacherTIME COMPLETED:
03:40 PM
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On 05/31/2023 at 1:45 PM Licensing Program Analyst (LPA) Katrina Chicote conducted an Unannounced- Case Management Inspection to follow up on an incident that was reported to The Department. Upon arrival, LPA announced purpose of inspection and met with Ines Leighton, Teacher, who granted entry to facility provided LPA a tour.

On 05/23/2023, an incident was reported to The Department where a child was injured requiring medical treatment. The facility reported this incident to The Department within the required 24 hours and written report was received within seven days.

During this inspection LPA interviewed staff present who stated they observed the incident and obtained and reviewed documentation. Per Teacher, she observed incident that occurred on the circle time rug where children were playing with soft Velcro blocks. Teacher states she was about to walk over to area where children were playing but child walked up to her first and showed her his finger. Teacher states she observed the finger to be red and asked the child to move it which they were able to do. Teacher states they applied ice, observed no further swelling, and wrote ouch report which was provided to the parent at pick up. Teacher states they were only made aware of child fracturing finger the next day when Parent called to inform them. LPA observed area at time of inspection where incident took place and where Teacher states she was positioned during incident.

Based on the information obtained through interviews and documents, LPA observation of the play area, LPA determined there was adequate supervision provided the day of the incident and no deficiency cited during today's visit.

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. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview and report reviewed with Facility Representative, Ines Leighton.
Report Ends - Page 1 of 1
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2023
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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