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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415770
Report Date: 02/06/2024
Date Signed: 02/06/2024 12:47:16 PM

Document Has Been Signed on 02/06/2024 12:47 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:CDC, INC. FRIENDSHIP ACADEMY CHILDREN'S CENTERFACILITY NUMBER:
197415770
ADMINISTRATOR:ALECIA COUTEEFACILITY TYPE:
850
ADDRESS:4120 WEST 185TH STREETTELEPHONE:
(310) 707-1423
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 119TOTAL ENROLLED CHILDREN: 119CENSUS: 43DATE:
02/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Gladys AnduezaTIME COMPLETED:
12:55 PM
NARRATIVE
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On 02/06/2024 at 9:30am, Licensing Program Analyst (LPA) Sarah Garcia conducted an unannounced case management-incident visit to follow-up on a self-reported unusual Incident (LIC 624) reported to Community Care Licensing on 01/22/2024. Upon arrival, LPA met with Supervisor, Gladys Andueza. LPA informed supervisor about the purpose of the visit and toured the facility. LPA observed 43 children with 14 staff.

LPA observed the following classrooms:

Bunnies: 5 children with 2 staff.

Ducks: 6 children with 2 staff.

Hummingbirds: 10 children with 3 staff.

Tigers: 11 children with 3 staff.

Dragonfly: 11 children with 2 staff.

According to the UIR, on 1/19/2024 at 11:28am, during outdoor playtime. C1 was sitting under the play structure. C1 was playing and moved his head back while laughing and hit the bottom of the play structure. C1 sustained a laceration to the back of the head/neck area. First aid was administered and parents were called at 11:30am. Parent arrived to the facility and transported C1 to Torrance Providence Hospital. C1 received 2 staples in the back of the head. C1 has returned to school with no restrictions on 1/22/2024.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: CDC, INC. FRIENDSHIP ACADEMY CHILDREN'S CENTER
FACILITY NUMBER: 197415770
VISIT DATE: 02/06/2024
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LPA Garcia conducted interviews with staff and children. LPA received the following documents: children’s roster, personnel roster, LIC 624, parent incident notification, physician's report, sign in/ sign out sheets, and witness statements. LPA took photographs of the outdoor play apparatus. Based on interviews and evidence provided, physical plant inspection of the site of the incident, it revealed that at the time of the incident, there were 11 children playing outdoors being supervised by two staff members. The preponderance of evidence to prove there was a lack of supervision has not been met.

Exit interview was conducted and a copy of the report was provided to supervisor, Gladys Andueza. Appeal rights were reviewed and provided. A notice of site visit was given and must remain posted for 30 days.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024
LIC809 (FAS) - (06/04)
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