Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671677
Report Date: 05/30/2018
Date Signed: 05/30/2018 03:05:44 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GROWING PLACE, THEFACILITY NUMBER:
191671677
ADMINISTRATOR:ANITA DE LA PUENTEFACILITY TYPE:
850
ADDRESS:401 ASHLAND BTELEPHONE:
(310) 399-7760
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY:86CENSUS: 71DATE:
05/30/2018
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Anita de la Puenta-Varisco, Center DirectorTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced case management incident inspection to follow up on the self reported incident that occurred at The Growing Place on April 26, 2018. The Culver City Child Care Office received the faxed incident report on April 30, 2018. LPA observed 71 children present being supervised by 9 staff at the time of this inspection. LPA verified that all adults present in the facility have obtained criminal record clearances and are associated to the facility. LPA also reviewed the sign in and sign out sheets to verify the census.

Reporter stated that on 04/26/18 at about 11:40 am, child#1 was playing with other children on the playground near the gazebo space. Child #1 tripped over another child’s foot causing him to fall down and cut his forehead as it hit a tree stump. The teacher who witnessed the incident applied gauze and ice to stop the bleeding. The parents were contacted by phone for pick up a few minutes after the incident occured. The parents arrived to pick up the child and took him to Urgent care where the child received 4 stitches to his forehead. During this inspection, LPA conducted interviews with the center director and staff member who witnessed the incident. LPA also obtained a copy of the child’s record as well as a copy of the sign in and sign out sheets for 04/26/18. Based on interviews with the facility staff and the child’s parent and information gathered, the facility was within ratio at the time of the incident. Center staff provided proper care and supervision during the time of the incident. At this time based on the available information it does not appear this incident was the result of a Title 22 violation.

LPA Martinez informed the facility that effective April 23, 2018 our office has relocated to the city of El Segundo. Our new address is 300 Continental Blvd. Suite 290A, El Segundo, CA 90245. Our Regional Office main line number is 424-301-3078 and the fax number is 424-301-3200. LPA provided an updated parent's right poster. The notice of site visit must be posted for 30 days upon receipt. An exit interview was conducted with Anita de la Puente-Varisco, Center Director.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2018
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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