<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418477
Report Date: 10/02/2024
Date Signed: 10/02/2024 09:12:13 PM

Document Has Been Signed on 10/02/2024 09:12 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CRYSTAL STAIRS INC- WONDERLANDFACILITY NUMBER:
197418477
ADMINISTRATOR/
DIRECTOR:
BARRERA, CIRENIAFACILITY TYPE:
850
ADDRESS:1223 SOUTH WILLOWBROOK AVENUETELEPHONE:
(310) 933-0792
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 24TOTAL ENROLLED CHILDREN: 15CENSUS: 13DATE:
10/02/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Karina RodriguezTIME 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) T. Tran made an unannounced visit at the above licensed facility to conduct a Case Management Incident that occurred on 09/06/2024. The Monterey Park Southwest Office received the written report on 09/10/2024. Upon arrival, LPA met with Site Supervisor, Karina Rodriguez and toured the facility. LPA observed proper care and supervision.

During today's visit, LPA completed child and staff’s files reviewed and obtained child's document and personnel report. Interviews were conducted with staff and others. Accordance to the interviews, on the day of the incident, there were 11 children outside at the playground with two qualified staff. Both on duty staff observed C1 (see LIC 811) tripped and hit the face on the children stationary bike handle. C1 sustained a cut on the upper lip. Staff immediately provided first aid and parent was contacted. C1 returned to school on 9/10/24 without any restrictions from the dentist. At this time based on the available information it does not appear this incident was the result of a Title 22 violation for lack of care and supervision.

No deficiency was found during today's inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Karina Rodgriguez.

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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 1