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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600684
Report Date: 05/21/2024
Date Signed: 05/21/2024 03:30:42 PM

Document Has Been Signed on 05/21/2024 03:30 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:FIRST LUTHERAN CIRCLE OF LOVE PRESCHOOLFACILITY NUMBER:
191600684
ADMINISTRATOR/
DIRECTOR:		NANCY J. DURKOVICFACILITY TYPE:
850
ADDRESS:1100 POINSETTIA AVE.TELEPHONE:
(310) 545-5653
CITY:MANHATTAN BEACHSTATE: CAZIP CODE:
90266
CAPACITY: 125TOTAL ENROLLED CHILDREN: 125CENSUS: 70DATE:
05/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:NANCY DURKOVIC, DIRECTORTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 5/21/2024, Licensing Program Analyst (LPA) Loyce Phillips, conducted a case management inspection to follow up on an Unusual Incident, reported to the department by telephone on 5/17/2024. LPA was greeted by Director, Nancy Durkovic. LPA toured the facility and took a census of the children. LPA observed 70 children in care with 14 staff members.

Description of the incident: On 5/16/2024 at approximately 2:45pm. C1 was running on the padded ground and fell down and scratched his leg/knee area. C1 complained that his arm was hurting. First aid was applied to legs and his arm was wrapped. Parent was called and arrived to the facility within 4 minutes. Staff assisted C1 to the car. Parent transported C1 to urgent care, where child needed to follow-up at the Orthopaedic Institute for Children. Child's left arm sustain a fractured elbow and broken wrist. C1 has returned back to the facility on 5/20/2024 with restrictions.

During this inspection, LPA toured the facility, interviewed staff, obtain a copy of the facility roster and inspected the play equipment and took photos of the outdoor play area.

Based on the information provided and interviews conducted further investigation is required.

An exit interview was conducted, a copy of this report and notice of site visit was provided to Director.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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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