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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191870556
Report Date: 07/30/2025
Date Signed: 07/30/2025 12:17:58 PM

Document Has Been Signed on 07/30/2025 12:17 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CABRILLO AVENUE EARLY EDUCATION CENTERFACILITY NUMBER:
191870556
ADMINISTRATOR/
DIRECTOR:		JACKSON, JOSEMIEFACILITY TYPE:
850
ADDRESS:741 W. 8TH ST.TELEPHONE:
(310) 832-2809
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY: 116TOTAL ENROLLED CHILDREN: 116CENSUS: 65DATE:
07/30/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:PAULA SWEARINGEN, PRINCIPALTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 07/30/2025, Licensing Program Analyst (LPA) Lisa Clayton, conducted a case management inspection to follow up on an Unusual Incident, reported to the department by telephone on 07/08/2025. LPA Clayton met with Principal Paula Swearingen. LPA Clayton observed 65 children in care, being supervised by 13 fingerprint cleared staff.

Incident Details: RP states on 6/17/25 at approximately 10:15am the Aide Took C1 to the restroom near Classroom 2B. RP states when the aide returned, she did not have C1 with her. RP states Coach Alma, noticed C1 did not return and found C1 on the play yard by herself. RP states the time C1 was left alone is unknown and parents were notified upon picking up of C1.

On 07/24/2025 LPA Clayton interviewed staff and observed the area where the incident occurred. LPA Clayton obtained a facility roster, personnel report and other documents pertinent to the incident and inspection.

During todays visit, LPA Clayton observed the child referenced in the complaint and interviewed the witness to the incident via telephone. LPA Clayton received a copy of the witnesses written statement.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: CABRILLO AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870556
VISIT DATE: 07/30/2025
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Based on LPA Clayton's record review and interviews with staff, both Type A and Type B Deficiencies were cited in accordance with Title 22 California Code of Regulations (see LIC 9099D's).

Principal Swearingen will provide parents of currently enrolled children and parents of children enrolled over the next 12 months copies of the Licensing Report containing the Type A violation and maintain the signed LIC 9224 in the children’s files.

An exit interview was conducted, the report and Appeal Rights were reviewed and provided to Principal Swearingen.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/30/2025 12:17 PM - It Cannot Be Edited


Created By: Lisa Clayton On 07/30/2025 at 11:15 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: CABRILLO AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870556

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/30/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision 101229 (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time,...... Supervision shall include visual observation.

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Director and staff to watch the Supervising Children in Child Care Centers video at ccld.childcarevideos.org and provide an individual written declaration of understanding to LPA Clayton and/or the Department no later than Friday August 8, 2025.
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This requirement was not met as evidenced by details provided in the self-reported UIR and LPA Clayton's interviews with staff confirmed that child referenced in the report was able to leave the building unsupervised and was found on play yard, posing 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.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Lisa Clayton
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/30/2025 12:17 PM - It Cannot Be Edited


Created By: Lisa Clayton On 07/30/2025 at 11:31 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: CABRILLO AVENUE EARLY EDUCATION CENTER
FACILITY NUMBER: 191870556

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2025
Section Cited
CCR
101212(a)(d)(1)(C)

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 (a) Each licensee or applicant shall furnish to the Department reports as required by the Department including,.... the following: (d) Upon the occurrence, during the operation of the child care center…..a report shall be made to the Department by...... Department's next working day and during its normal business hours. In addition, a written report …….(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.
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Principal Swearingen will ensure that all Unusual Incindents that meet the Title 22 Regulation requirements are reported 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 shall be submitted to the Department within seven days following the occurrence of such event.
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This requirement was not met as evidenced by the: the incident occurred on 06/17/2025 and was reported to the Department on 07/08/2025 via telephone, posing 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.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Lisa Clayton
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2025


LIC809 (FAS) - (06/04)
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