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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400693
Report Date: 06/06/2024
Date Signed: 06/06/2024 10:47:06 AM

Document Has Been Signed on 06/06/2024 10:47 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:GROWTH LAB, THEFACILITY NUMBER:
198400693
ADMINISTRATOR/
DIRECTOR:
SWAIN, SHARONIECEFACILITY TYPE:
830
ADDRESS:522 W VERNONTELEPHONE:
(323) 385-6482
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY: 11TOTAL ENROLLED CHILDREN: 11CENSUS: 6DATE:
06/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Nayeli De CasasTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On 6/6/24 at 10:00 AM Licensing Program Analysts (LPA) Claudia Kam conducted an Unannounced Case management Inspection to follow up on an incident that was reported to the Department on 05/13/24. Upon arrival, LPAs announced purpose of inspection and met with Facility Representatives, who granted entry to facility. Census was taken 6 infant children present with 2 staff.

On 5/13/2024, an incident was reported to The Department where a child sustained an injury while in care. The facility reported this incident to the Department within the required 24 hours and submitted written report within seven days.

During this inspection LPA interviewed staff, observed room where incident took place, per teacher the child dis-enrolled after the incident and therefore LPA was unable to observe child named in report. Teacher informed Licensing that the child was jumping on the mattress in the crib and began to lean over the railing. Upon leaning too far the child fell out of the crib. The teacher states that the incident occurred during nap time and that there were 2 staff present monitoring when the incident occured. Teacher states they applied immediate first aid, and soothed the child. Teacher states that after child continued to play and injury did not appear to stop child from daily activities. Parent was informed and child picked up immediately. Per Teacher, parent dis-enrolled the child and the child never returned after the incident. Teacher is not aware of any follow up medical care. LPA observed the nap room where the incident took place and observed the cribs to be wooden cribs with clear paneled walls and to be in good condition at time of inspection and meet regulation standard (photos taken). Per teacher to avoid further incident they have removed extra cribs and only kept the 2 needed for the infants under 12 months. All mobile children have been placed on cots. Based on the information obtained and LPA observation LPA determined there was adequate supervision and Facility Representatives made necessary adjustments after incident.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.
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.
Report Ends - Page 1 of 1

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2024
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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