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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191200671
Report Date: 12/18/2024
Date Signed: 12/18/2024 01:56:54 PM

Document Has Been Signed on 12/18/2024 01:56 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:NURTURY, THEFACILITY NUMBER:
191200671
ADMINISTRATOR/
DIRECTOR:		DEBRA KAUFMANFACILITY TYPE:
850
ADDRESS:14401 DICKENSTELEPHONE:
(818) 990-8352
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91423
CAPACITY: 38TOTAL ENROLLED CHILDREN: 29CENSUS: 22DATE:
12/18/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:34 AM
MET WITH:Norma MontesTIME VISIT/
INSPECTION COMPLETED:
12:58 PM
NARRATIVE
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On 12/18/2024, Licensing Program Analyst (LPA) Suzette Ornelas conducted an unannounced case management inspection for the purpose of deficiencies observed during a complaint investigation control # 58-CC-20241213085810. Upon arrival LPA was greeted by Director, Norma Montes and observed 22 children and 6 adults.

LPA Ornelas investigated complaint control #58-CC-20241213085810. According to the complaint investigation report received on 12/13/2024, there was a damage to the ceiling panels in a preschool classroom due to a water leak at the facility on 12/8/2024 (Sunday).

Based on interview conducted with the Director, stated that she did not report the incident to the licensing department. It was confirmed that the incident was not reported to the Department within 24 hours. No direct contact with the on duty worker or the analyst was made within 24 hours.

LPA explained to the licensee that when an incident occurs, according to Title 22 Regulations, the incident must be reported to the department within 24 hrs., and a written report using the unusual incident /injury report LIC624 form must be filled out and mailed to the department within 7 days. Director understands and will comply.

The following Type B deficiency is being cited on 12/18/2024 in accordance to Title 22 of the California Code of Regulations: Reporting Requirements101212 (d)(1)(C). Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1)Events reported shall include the following: (C)Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: NURTURY, THE
FACILITY NUMBER: 191200671
VISIT DATE: 12/18/2024
NARRATIVE
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 Please refer to 809D for cited deficiencies.

A copy of this report, notice of site visit, and appeal rights were provided. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Director.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/18/2024 01:56 PM - It Cannot Be Edited


Created By: Suzette Ornelas On 12/18/2024 at 10:20 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: NURTURY, THE
FACILITY NUMBER: 191200671

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/03/2025
Section Cited
CCR
101212(d)(1)(C)

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101212(d)(1)(C) - Reporting Requirements (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1)Events reported shall include the following: (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. This requirement is not met as evidence by:
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Director will complete LIC624 and provide a copy to LPA via email on or before 1/3/2025.
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Based on observations and interviews, Unusual incident was not reported to the department withing 24 hours via telephone/in writting within 7 days. This poses a potential 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:Raul Navarro
LICENSING EVALUATOR NAME:Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:
DATE: 12/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2024


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