Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671677
Report Date: 02/12/2019
Date Signed: 02/12/2019 09:19:14 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: 4DATE:
02/12/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
07:44 AM
MET WITH:Wendy Hurtado, TeacherTIME COMPLETED:
08:05 AM
NARRATIVE
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On 02/12/2019 at 07:44 am, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced case management inspection to the facility to deliver the amended investigation findings of the incident that was self-reported by the facility and occurred on 12/12/2018. LPA met with Wendy Hurtado, teacher, 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.

After further investigation it was determined that due to a lack of proper supervision child #1 got hit from the swing resulting in an injury that required medical attention. The incident was reported immediately, and staff did properly assess and provide medical attention to the injured child. Based on reports and interviews conducted the facility was cited for a violation of Title 22 section 101229(a)(1) Care and Supervision.

Upon receipt of a citation for a Type A Deficiency, the director shall post the licensing report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report (LIC 809D/9099D) to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file.

An exit interview was conducted and a copy of this report, appeal rights along with the notice of site visit were provided to Wendy Hurtado.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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, THE
FACILITY NUMBER: 191671677
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/13/2019
Section Cited
CCR
101229(a)(1)
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Care and Supervision. No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1). This requirement is not met as evidenced by: based on interviews conducted, on
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Facility staff shall have a meeting reiterating what is required of supervision and a plan shall be devised to ensure the coverage of staff during breaks or absence of supervision. The training agenda along with the staff sign in and sign out sheet shall be mailed or faxed to the Department no later than February 13, 2019.

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12/12/2018, child #1 sustained an injury which required medical attention due to lack of proper supervision. Staff failed to visually supervise child while playing in the swing area. This is an immediate risk to children in care and a type A citation was issued.
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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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
LIC809 (FAS) - (06/04)
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