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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494322
Report Date: 04/17/2025
Date Signed: 04/17/2025 01:04:13 PM

Document Has Been Signed on 04/17/2025 01:04 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:CRYSTAL STAIRS HEAD START - JEFFERSON FELTONFACILITY NUMBER:
197494322
ADMINISTRATOR/
DIRECTOR:		CARDENAS, LAURAFACILITY TYPE:
850
ADDRESS:10521 HAWTHORNE BLVDTELEPHONE:
(323) 421-2662
CITY:INGLEWOODSTATE: CAZIP CODE:
90304
CAPACITY: 75TOTAL ENROLLED CHILDREN: 70CENSUS: 52DATE:
04/17/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Shaunee Bereaux, Educational CoordinatorTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
NARRATIVE
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On 4/17/2025 @ 9:15am, Licensing Program Analyst (LPA) Devon Carus conducted a Case Management Unusual Incident inspection to follow up on the self- reported incident that occurred on 04/8/2025 at CRYSTAL STAIRS HEAD START - JEFFERSON FELTON located at 10521 Hawthorne Blvd. Inglewood, CA 90304. The El Segundo Regional Office received the incident report on 4/9/2025. Upon arrival, LPA met with Shaunee Bereaux, educational coordinator. LPA observed 52 children being supervised by seven staff members. All center staff that was present during today’s inspection had fingerprint clearance and are associated to the designated license number.

LPA interviewed the following: Staff member #2 (S2) as the witness, and the coordinator Staff #1 (S1). During LPA Carus' visit, both Child #1 (C1) and Child #2 (C2) were absent. The incident happened towards the beginning of the day around 11:30am before lunch time inside of the 3-5 year old classroom. S2 initially noticed the incident, and was first to treat the child's wound with ice packs. Based on the information gathered through interviews, and visual inspection of the classroom (site of the incident), it revealed that there were two adults supervising 14 children.

According to the narrative provided by S1 and S2, the incident took place before lunch time inside of the classroom. C2 was throwing a tantrum, and S2 went to console her. C2 then pushed S2 away from her and C2 then pushed a children’s shelf in the classroom that fell on C1’s ankle. C1 was treated by S2 with an ice pack, and proceeded to contact the child’s parents. C1 was then taken to the hospital by way of ambulance, and the child’s parents then picked him up there. C1 returned two days later with a bruise, and a doctor’s note stating that there were not any sprains, breaks, or fractures. Additionally, C1 had no restrictions upon return.

NAME OF LICENSING PROGRAM MANAGER: Maureen Neal
NAME OF LICENSING PROGRAM ANALYST: Devon Carus
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CRYSTAL STAIRS HEAD START - JEFFERSON FELTON
FACILITY NUMBER: 197494322
VISIT DATE: 04/17/2025
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Prior to this incident, the pre school has made attempts to inform the legal guardian of C2 that the child needs additional care regarding behavior that the school cannot provide. The school informed LPA Carus that the guardians of C2 have not responded positively to the recommendations of additional care and believe the school can teach the child what is necessary despite multiple attempts by the staff. During today’s visit, the crystal stairs staff coordinator confirmed that since this incident occurred, the pre school is not allowing C2 to return to care until their guardians can provide proof that they are receiving care from a behavioral therapist.

At this time based on the available information, there will be no violations cited today.

The content of this report was read and discussed in detail with Shaunee Breaux, educational coordinator.

An exit interview was conducted. The notice of site visit must be posted for 30 days upon receipt.

NAME OF LICENSING PROGRAM MANAGER: Maureen Neal
NAME OF LICENSING PROGRAM ANALYST: Devon Carus
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC809 (FAS) - (06/04)
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