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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400569
Report Date: 08/29/2024
Date Signed: 08/29/2024 01:09:18 PM


Document Has Been Signed on 08/29/2024 01:09 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:DREW CDC - RAINBOWFACILITY NUMBER:
198400569
ADMINISTRATOR:HERNANDEZ, RAYMONDFACILITY TYPE:
850
ADDRESS:11817 WILMINGTON AVE.TELEPHONE:
(323) 249-2950
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:88CENSUS: 35DATE:
08/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jessica Osorio, Site SupervisorTIME COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Alicia Mooberry and Peter Bishop conducted an unannounced case management inspection on this date 8/29/24. LPAs met with facility representative, to discuss the incident reported on 8/21/24. At the time of arrival LPAs observed 35 children in care with 8 staff.

During this visit LPAs recorded observations, reviewed documents and interviewed 2 staff and child #1.

Information receive from the facility indicates that on 8/21/24 a child was left unattended in classroom while the rest of the class walked down the corridor toward outside to playground.

During visit, statements were provided by Staff #1 and Staff #2, which confirmed that child #1 was left unsupervised in the classroom R12-L for approximately one (1) minute. The child was taken by Staff #1 to Staff #2, while the children were in hallway. Records show that the classroom was within ration.

Interview with child #1 did not provide any disclosures regarding the incident.



Based on interviews which were conducted the facility did not ensure Child #1 was supervised all all times and was left unsupervised for one (1) minute, which is a potential risk to the health and safety of children in care. California Code of Regulations, (Title 22, Division 12 Chapter 1, 101229(a)(1)) is being cited, One (1) "B" is cited on attached deficiencies page.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative, Jessica Osorio.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024
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 2


Document Has Been Signed on 08/29/2024 01:09 PM - It Cannot Be Edited

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: DREW CDC - RAINBOW
FACILITY NUMBER: 198400569

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/03/2024
Section Cited
CCR
101229(a)(1)

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The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time. This requirement is not met as evidenced by:
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Per Jessica Osori, Site Supervisor, the incident was reported to the HR department and a plan to review the supervision policy is in place. Supervision of children will be addressed at all staff meeting on 8/30/24. A copy of training agenda will be provided to Department by POC due date.
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Based on interviews conducted with Staff #1, Staff #2 and Child #1, who confirmed child #1 was left unattended for approximately one minute in classroom. This poses a potential risk to the health and safety of 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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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