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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419837
Report Date: 12/12/2022
Date Signed: 12/12/2022 03:26:37 PM

Document Has Been Signed on 12/12/2022 03:26 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:LAUNCHING PAD, THEFACILITY NUMBER:
197419837
ADMINISTRATOR:THORSTENSON-ROOT, RFACILITY TYPE:
850
ADDRESS:3707 DOOLITTLE DRIVETELEPHONE:
(310) 536-0243
CITY:REDONDO BEACHSTATE: CAZIP CODE:
90278
CAPACITY: 141TOTAL ENROLLED CHILDREN: 92CENSUS: 82DATE:
12/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Teresa Antonelli TIME COMPLETED:
12:00 PM
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On 12/12/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced Case Management – Incident inspection to follow up on the Unusual Incident Report (UIR) submitted on 11/23/2022. Upon arrival, LPA met with Field Director, Teresa Antonelli. LPA observed 82 children with 15 teachers.

According to the UIR, on 11/23/2022 at approximately 9:30AM, Staff 1 (S1) was in the restroom with 4 children. S1 was assisting a child with hand washing, when Child 1 (C1) was getting off the toilet and lost his footing on the step stool. The step stool slid and C1 fell forward, hitting his head on a stool. S1 noticed bleeding above C1's right eyebrow, and S1 immediately assisted C1. C1's parents were called and C1 was taken to the ER. C1 received 6 stiches. C1 returned to the facility on 11/28/2022.

During today's inspection, LPA conducted a tour of the facility and interviewed Field Director and S1. LPA closely inspected the restroom where the incident occurred. A non-slip mat has been added to the area around the toilet to prevent the incident from reoccurring. Field Director disclosed this restroom is for temporary use as the children's classrooms had been remodeled. Children will return to permanent classrooms on 12/19/2022. Restrooms in the permanent classrooms include children's toilets. Field Director non-slip mats are placed around restroom sinks.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

An exit interview was conducted. A copy of this report (LIC 809) and Notice of Site Visit were provided to Field Director, Teresa Antonelli.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2022
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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