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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192000284
Report Date: 11/14/2024
Date Signed: 11/14/2024 12:37:33 PM

Document Has Been Signed on 11/14/2024 12:37 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:IGLESIA BAUTISTA/FRIENDSHIP CHILDREN'S CENTERFACILITY NUMBER:
192000284
ADMINISTRATOR/
DIRECTOR:		NAOMI LOPEZFACILITY TYPE:
850
ADDRESS:931 FRIGATE AVENUETELEPHONE:
(310) 518-8854
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY: 130TOTAL ENROLLED CHILDREN: 130CENSUS: DATE:
11/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:06 AM
MET WITH:Naomi LopezTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 11/14/2024, Licensing Program Analyst (LPA) Tyra Chavies conducted an unannounced case management- incident visit to follow-up on a self- reported unusual Incident (LIC 624) reported to Community Care Licensing on 11/07/2024. Upon arrival, LPA met with staff member Brenda Chavez.  LPA informed Ms. Chavez about the purpose of the visit and toured the facility. LPA observed children 72 being supervised by 12 teacher. Around 9:40 am LPA Chavies met with Noemi Lopez, who is the director.
Incident Details:
RP stated that on 11/07/2024 at approximately 9:40 am the children where outside in the yard playing Green Light Red Light. C1 above ran straight in the path of the children playing and bump on the C2 and fell to the ground injuring her left knee and left side of Collar Bone.

On 11/14/2024 LPA Chavies observed children in care, conducted interviews with Director,  S1, S2, S3, S4, C1, C2 and C3, P1 received personnel documents, children's roster, sign in/out sheets, medical documents and a copy of the video regarding incident. Based on interviews conducted, review of all documentation and video, staff and director followed the policies and producers in regards to supervision and personal rights. Physical plant is following title 22 of the health and safety regulations.

No deficiencies were cited.

Exit interview was conducted and a copy of the report was provided to director, Noemi Lopez.

Notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Tyra Chavies
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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