Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671677
Report Date: 01/17/2019
Date Signed: 01/17/2019 11:35:22 AM

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: 65DATE:
01/17/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:28 AM
MET WITH:Anita Dela Puente, Center DirectorTIME COMPLETED:
11:45 AM
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On 01/17/2019 at 10:28 am, Licensing Program Analyst (LPA) Sabrina Martinez arrived at The Growing Place for the purpose of following up on the unusual incident that occurred on 12/12/2018. The written unusual incident report was received by the El Segundo Regional Office on 12/13/2018. LPA met with Anita Dela Puente, center director, and discussed the purpose of the visit.

According to the report, child #1 was walking in the sand towards the swing structure. Another child had left the swing in movement and child #1 walked into the side of the swing. Child #1 got cut on the left side of his face from the swing. Staff immediately applied towels to stop the bleeding and paramedics were called. The child's father was contacted and arrived at the facility as well. The child was taken to UCLA- Santa Monica Emergency room and was given stitches. The child returned to the facility on 12/14/2018.

During this inspection, LPA conducted interviews with the facility staff and the child involved in the incident.

At this time, further investigation is needed.

An exit interview was conducted and a copy of this report was provided to Anita Dela Puente, Center Director.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2019
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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