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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021223
Report Date: 10/25/2024
Date Signed: 10/25/2024 02:50:50 PM

Document Has Been Signed on 10/25/2024 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PATHWAYS LAFACILITY NUMBER:
198021223
ADMINISTRATOR/
DIRECTOR:		LAKENDRA WILLIAMSFACILITY TYPE:
830
ADDRESS:1 GATEWAY PLAZATELEPHONE:
(213) 427-2700
CITY:LOS ANGELESSTATE: CAZIP CODE:
90012
CAPACITY: 36TOTAL ENROLLED CHILDREN: 23CENSUS: 15DATE:
10/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Lakendra Williams, Site Supervisor & Shannon Huston, Director of Family of Child Care Provider ServicesTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On October 25, 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 La Kendra Williams, Site Supervisor and Shannon Huston, Director of Family of Childcare Provider Services, who guided LPA on a tour of the facility. This facility is located on the premises of Union Station Los Angeles and operates out of 2 levels (lower and upper). There is also a preschool program (198021224) that operates on the same premises as the infant program. Census was taken.

On 10/9/2024, it was reported to the department that on 10/7/2024, C#1 was walking toward the sink to wash hands after lunch, C#1 tripped over their feet falling into the steps used to wash their hands. C#1 mouth hit the bottom step and it started bleeding. Parent was notified immediately, and parent arrived minutes later due to parent still at facility parking lot and parent took C#1 to seek emergency medical treatment. C#1 sustained 3 stitches in the gum area of the mouth. C#1 returned to school the follow day, 10/08/2024, with a doctor’s note with no restrictions. Staff present stated that incident was observed, and incident happened so fast it was unable to be prevented. The incident was not reported to the Department within the 24-hour period. Per Director Shannon Houston report was called into the department on the day of the incident and was told to submit LIC 624 written report only. Due to miss communication and department error, no reporting requirement violation will be given.

LPA Perry did obtain and review video footage from facility. Based on information obtained and video footage, there were no corroborating information to determine that there was a lack of supervision during the incident nor a personal rights violation. This incident has been determined to be an accident that could have not been prevented.

No deficiencies will be 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 Shannon Huston and La Kendra Williams.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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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