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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494018
Report Date: 04/09/2024
Date Signed: 04/09/2024 12:50:36 PM

Document Has Been Signed on 04/09/2024 12:50 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:MARTIN LUTHER KING JR. LEARNING CENTER PRESCHOOLFACILITY NUMBER:
197494018
ADMINISTRATOR/
DIRECTOR:
CAMARENA,E & LUNA,RFACILITY TYPE:
850
ADDRESS:12029 S WILMINGTON AVETELEPHONE:
(424) 338-1980
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: DATE:
04/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Arleesha HerdTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On 4/8/24 at 12:15 PM Licensing Program Analysts (LPA) Claudia Kam and Katrina Chicote conducted an Unannounced Case management Inspection to follow up on an incident that was reported to the Department on 4/4/24. Upon arrival, LPAs announced purpose of inspection and met with Facility Representative Assistant Director Arleesha Herd, who granted entry to facility. Census was taken and there were 53 children in attendance at time of visit.

On 04/04/24, an incident was reported to The Department where a child sustained an injury while in care. The facility reported this incident to the Department within the required 24 hours and submitted written report within seven days.

During this inspection LPAs interviewed staff, observed room incident took place in, and observed child named in report. Assistant director stated that the child was playing during dramatic play and upon leaving the play area slipped and fell back hitting his head on the carpeted area causing injury to the child. Assistant Director states that the Teacher observed the incident and parents were notified immediately of the incident. 911 was contacted immediately, paramedics provided first aid child and took child to the hospital. Child was attended to at the hospital and was cleared to return the next day. Assistant Director states that they have updated their shoe policy and will be sending the new policy to parents as a result of the incident to prevent future slip and falls. LPAs observed the indoor classroom where the incident took place and observed the area and child napping at time of inspection. Based on the information obtained and LPAs observation LPAs determined there was adequate supervision and Facility Representatives made necessary adjustments after incident.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.
A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Facility Representative.
Report Ends - Page 1 of 1

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Claudia Kam
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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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