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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019906
Report Date: 05/23/2022
Date Signed: 05/23/2022 04:50:29 PM

Document Has Been Signed on 05/23/2022 04:50 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:EDUCARE LOS ANGELES AT LONG BEACHFACILITY NUMBER:
198019906
ADMINISTRATOR:MARIA HARRISFACILITY TYPE:
830
ADDRESS:4840 LEMON AVETELEPHONE:
(562) 422-6618
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 60TOTAL ENROLLED CHILDREN: 48CENSUS: 33DATE:
05/23/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:LaShell Diggs, Program DirectorTIME COMPLETED:
05:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced case management inspection due to an incident that occurred on 05/20/22. LPA met with, Program Specialist, Sonia Gutierrez, who guided LPA on a tour of the facility. There were 33 children and 9 staff present upon arrival. LPA was later met by Program Director, LaSHell Diggs.

The purpose of the visit was to follow-up on an incident that was reported to the department.

LPA conducted interviews and obtained documentation during this visit.

The incident that occurred on 05/20/22, was reported to the Department on 05/20/22, via telephone. The facility reported the Unusual Incident to the Department within the required 24 hours of occurrence.

Information reported to the Department indicated that Child #1 required medical attention.

Based upon information received from the interviews conducted it was determined that the child's medical attention could have been prevented if facility would have followed Child #1s individualized health care plan. Child #1 was provided a food item in which they have allergies to. In addition, the facility did not comply with the limitations of the license due to child exceeding the age requirement in which the facility is licensed for.

The following deficiencies listed on the attached deficiency page are being cited in accordance with California Code of Regulations Title 22.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2022
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: EDUCARE LOS ANGELES AT LONG BEACH
FACILITY NUMBER: 198019906
VISIT DATE: 05/23/2022
NARRATIVE
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A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee/Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this 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. Exit interview was conducted with LaShell Diggs, Program Director, including, but not limited to Provider Rights, Appeal Procedures.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/23/2022 04:50 PM - It Cannot Be Edited


Created By: Rita Ramos On 05/23/2022 at 04:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: EDUCARE LOS ANGELES AT LONG BEACH
FACILITY NUMBER: 198019906

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/24/2022
Section Cited
CCR
10227(7)(B)

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Food Services
(7)Modified diets prescribed by a child's physician as a medical necessity shall be provided. (B)A child shall not be served any food to which the child's record indicates he/she has an allergy.
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Per Program Director, staff will be trained in medical and diet procedures for both the kitchen and the classroom. A copy of the training agenda with staff signatures will be submitted by POC due date.
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This requirement was not met as evidenced by Child #1's individualized health care plan not being followed. Child #1 was provided a food item that they were allergic to which required Child #1 needing medical attention which poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/23/2022 04:50 PM - It Cannot Be Edited


Created By: Rita Ramos On 05/23/2022 at 04:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: EDUCARE LOS ANGELES AT LONG BEACH
FACILITY NUMBER: 198019906

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2022
Section Cited
CCR
101161(a)

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Limitations on Capacity

(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
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Per Program Director, classroom structures will change and a roster showing configuration will be submitted by POC due date.
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This requirement is not met as evidenced by observation and record review indicating that Child #1 exceeds the age requirement in which the facility is licensed for which poses a potential health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2022


LIC809 (FAS) - (06/04)
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