191202449-11-21-2024-33-CC-SLII-DB8VB6-20241121151702

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191202449
Report Date: 11/21/2024
Date Signed: 11/21/2024 03:17:11 PM

Document Has Been Signed on 11/21/2024 03:17 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	HASTINGS RANCH NURSERY SCHOOL		FACILITY NUMBER:	191202449
ADMINISTRATOR/ DIRECTOR:	D.JOHNSON/A.RANGEL		FACILITY TYPE:	850
ADDRESS:	3740 E SIERRA MADRE BLVD		TELEPHONE:	(626) 351-9171
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY: 65	TOTAL ENROLLED CHILDREN: 94	CENSUS: 16	DATE:	11/21/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:35 PM
MET WITH:	Director Emily Quintero		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced Case Management inspection due to an incident that occurred on 11/8/24 and was reported to the Department on 11/8/24. A COVID risk assessment was conducted. LPA met with Director Emily Quintero to whom the reason for the visit was explained. Director guided LPA on a tour of the facility. There were 16 children present and 4 staff. Program is a Co-op with parent volunteers. The facility was observed to be operating within the license capacity limitations. On 11/8/2024, an unusual incident report was made to the Department regarding an injury that occurred during Am outdoor playtime. 3 year old child was climbing up a ladder attached to the play structure. The clean up bell sounded and teacher turned her view to usher the other children into the classroom. When teacher turned back around her she saw the 3 year child who was climbing land in the sand face down from a fall. The teacher assisted the child to get cleaned up and provide first aid. Immediate first aid was provided and parents were contacted right away. Child vocalized to teacher that he had hit his head while falling. Teaching staff did not observe any visible mark on child’s head. Per director, she assessed child’s skull and felt a significant dent in the back of his head behind his left ear and contacted parent immediately. Parent arrived and director drove mom and child to CHLA ER, where child received a CT scan of his head. Parent reported back that child had a depressed parietal skull fracture. Child has no special or developmental needs. Child returned to school the next day with restricted movement. Child is not allowed to ride bikes or play on structure for two weeks. Case is not closed per CHLA, follow up health visit required. Page 1 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HASTINGS RANCH NURSERY SCHOOL	FACILITY NUMBER: 191202449
	VISIT DATE: 11/21/2024

NARRATIVE

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During todays visit, LPA interviewed director, reviewed play structure, child’s file, and teachers’ files. LPA observed that play structure does not have label for targeted age development. LPA observed that structure has two climbing ladders side by side within one and a half feet apart from each other. On the right side of the right ladder is a small slide that turns towards the ladders two feet away.

LPA advised that climbing ladder fall zones are not in compliance with playground safety fall zone guidelines. Per Director, play structure was installed more than 10 years ago. Per Director, no prior incidents or injuries have occurred from the ladders during her employment. LPA advised that changes will need to be made to meet the playground fall zone safety guidelines and provided Director a copy of the playground guidelines. LPA advised that the climbing ladder on the right needs to be removed and opening at the top of the structure needs to be made in assessable.

Per Director, she needs to present the situation to the Board of Directors for play structure corrective actions. Board meeting is 12/11/24. Director will communicate updates after the board meeting to LPA via email. In the meantime, she is closing the play structure and going to use the remainder of the yard with appropriate toys and equipment for outdoor playtime until Board Decision is made. Director will look into ordering proper padding for the blue ladder and bumpers for the edge of the curved yellow slide. Director met with all lead teachers and brainstormed plans to provide extra supervision. Photos of structure and ladders were captured. Emergency visit records were requested. First page of ER visit was provided.

Based on information obtained during this investigation, follow up is necessary regarding the incident reported. No deficiencies are being cited at this time.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Emily Quintero. Page 2 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

LIC809 (FAS) - (06/04)

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