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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400231
Report Date: 03/18/2025
Date Signed: 03/18/2025 11:38:38 AM

Document Has Been Signed on 03/18/2025 11:38 AM - 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:NU BUILDING BLOCK INFANT CENTERFACILITY NUMBER:
198400231
ADMINISTRATOR/
DIRECTOR:		PEYTON SOLOMONFACILITY TYPE:
830
ADDRESS:2141 W JEFFERSON BLVDTELEPHONE:
(323) 732-5439
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 3DATE:
03/18/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Peyton SolomonTIME VISIT/
INSPECTION COMPLETED:
11:15 PM
NARRATIVE
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On 3/18/2025 at 9:40 AM Licensing Program Analyst (LPA) Claudia Kam conducted an Unannounced Case Management Inspection for the purpose of discussing and incident that occurred 4/12/24. LPA announced purpose of inspection and was granted entry by Facility Representative (FR), Yadira Godlock. Census was taken.

After review of video camera footage provided by Licensee, it was observed that Staff One (S1) hit Child One (C1) on the back of the head with an open hand after C1 swung a toy phone in the direction of another child. S1 was also observed handling various other children in a rough manner by pushing them, forcefully grabbing and sitting children down, and forcefully holding a child’s arms down while rocking them to sleep.

Per Facility Representative S1 no longer works at facility, their last day present was 4/26/25.

Based on this information the following deficiencies on the LIC 809 D are being cited today 3/18/2025.

LPA Claudia Kam informed director Peyton Solomon that this report dated 3/18/2025 documents one (1) Type A citation which shall be posted for 30 consecutive days as there are immediate risk to the health, safety, or personal rights of children in care.



Also, LPA Claudia Kam informed the facility representative to provide a copy of this licensing report dated 3/18/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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 Yadira Godlock and Peyton Solomon.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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Document Has Been Signed on 03/18/2025 11:38 AM - It Cannot Be Edited


Created By: Claudia Kam On 03/18/2025 at 10:47 AM
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: NU BUILDING BLOCK INFANT CENTER
FACILITY NUMBER: 198400231

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/18/2025
Section Cited
CCR
101223(a)(3)

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(a)The licensee shall ensure that each child is accorded the following personal rights:
(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature…
This regulation was not met as evidenced by:
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Staff was placed on leave 4/17/24 for another concern and no longer works at facility as of 4/26/24. A training was conducted with staff regarding health and Safety and personal rights. LPA was provided a copy of the training material and staff who attended. POC cleared 3/18/25
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Based on observation, the licensee did not prevent punishment of a child, as staff was witnessed hitting a child which poses an immediate Health, Safety and Personal Rights risk to persons 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:Denise Gibbs
LICENSING EVALUATOR NAME:Claudia Kam
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2025


LIC809 (FAS) - (06/04)
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