Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418675
Report Date: 04/04/2019
Date Signed: 04/04/2019 02:51:39 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:BRIGHT HORIZONS@OCEAN PARKFACILITY NUMBER:
197418675
ADMINISTRATOR:ESCORPISO, MARY JANEFACILITY TYPE:
830
ADDRESS:3350 OCEAN PARK BLVD.,STE.100TELEPHONE:
(310) 452-1919
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY:48CENSUS: 18DATE:
04/04/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:58 PM
MET WITH:Nara Keheyan, Center DirectorTIME COMPLETED:
03:15 PM
NARRATIVE
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On 04/04/2019, Licensing Program Analyst (LPA) Sabrina Martinez made an unannounced visit to the above mentioned facility for the purpose of citing deficiencies observed during an annual/random inspection conducted on 03/28/2019.

The following were observed:

On 03/28/2019 at 01:31 pm, LPA Martinez conducted a tour of Infant Room #2. LPA observed 6 infants being supervised by staff #1 and Ashley Woolfolk. LPA verified that all adults present in the room have obtained criminal record clearances/exemptions and are associated to the facility. LPA did not observe a criminal record clearance or criminal record exemption for Ashley Woolfolk.

On 03/28/2019 at 2:30 pm, LPA conducted a tour of the infant yard. LPA observed Goretty Monsalvo providing care and supervision to infants in the infant yard. LPA verified that all adults present in the infant yard have obtained criminal record clearance/exemptions and are associated to the facility. LPA did not observe a criminal record clearance or criminal record exemption for Goretty Monsalvo.

Deficiencies were observed and Type A citations will be issued today, 04/04/2019. Civil penalty in the amount of $1000 was assessed. See 809-D for deficiencies cited.

AB 633 was discussed:

This bill requires that, upon receipt, a licensed child care facility shall provide to the parents or guardians of each child receiving services in the facility:


SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2019
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: BRIGHT HORIZONS@OCEAN PARK
FACILITY NUMBER: 197418675
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/04/2019
Section Cited
CCR
101170(e)(3)
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Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:Request and be approved for a transfer of a criminal record exemption, as specified in Section 101170.1(r), unless, upon request for a transfer, the Department
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Center Director faxed Ashley Woolfolk's LIC 9188, LIC 508 along with the job descriptions to the Caregiver Background Check Bureau on 03/28/2019. LPA was also provided with copies of the documents.Deficiency cleared today and a copy of the clearance letter was provided today, 04/04/2019.
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permits the individual to be employed, reside or be present at the facility. This requirement is not met as evidenced by: On 03/28/19 at 01:31 pm, LPA observed Ashley Woolfolk providing care to infants. LPA did not observe a criminal record clearance/exemption for Ashley Woolfolk. This is an immediate health and safety risk to children in care.
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Type A
04/04/2019
Section Cited
CCR
101170(e)(2)
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Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f)
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Center Director provided LPA with a copy of Goretty Monsalvo's LIC 9182, LIC 508 and US issued government ID.

Deficiency cleared today and a copy of the clearance letter was provided today, 04/04/2019.
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This requirement is not met as evidenced by: On 03/28/2019 at 2:30 pm, LPA observed Goretty Monsalvo providing care and supervision to infants in the infant yard. LPA did not observe a criminal record clearance/exemption for Goretty Monsalvo. This is an immediate health and safety risk to 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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2019
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: BRIGHT HORIZONS@OCEAN PARK
FACILITY NUMBER: 197418675
VISIT DATE: 04/04/2019
NARRATIVE
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  1. Copies of any licensing report that documents any Type A citation. This includes facility visits and substantiated complaint investigations.
  2. Any licensing documents pertaining to a conference conducted by a local licensing agency management representative with the licensee in which issues of noncompliance are discussed.
  3. Copies of a summary of an accusation indicating the Department’s intent to revoke the license, until that accusation is either dismissed or resolved through the administrative hearing process or stipulated agreement.
  4. Copies of any of the above licensing documents that the licensee has received in the prior 12-month period shall be provided to the parents of newly enrolling child, upon enrollment.
An exit interview was conducted and a copy of this report along with the notice of site visit and appeal rights were provided to Nara Keheyan, Center Director.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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