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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000639
Report Date: 04/06/2023
Date Signed: 04/06/2023 10:24:15 AM

Document Has Been Signed on 04/06/2023 10:24 AM - 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:YOUNG HORIZONS INFANT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198000639
ADMINISTRATOR:ARIANA CHAVEZFACILITY TYPE:
830
ADDRESS:501 ATLANTIC AVETELEPHONE:
(562) 437-8991
CITY:LONG BEACHSTATE: CAZIP CODE:
90802
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 27DATE:
04/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Ariana ChavezTIME COMPLETED:
10:25 AM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management Incident inspection. This inspection is regarding an incident that took place on March 29, 2023. LPA met with Site Supervisor Ariana Chavez who assisted with the inspection.

LPA observed a video and conducted an interview with staff #1 and #2. Both staff attended to child #1 in regards to a possible incident that took place at the facility. Staff #1 indicated that staff #1 was holding hands walking with child #1 (who had both hands raised in the air). Then child #1 threw himself to the floor possibly sustaining an injury. Staff #2 did not witness the child throwing himself to the floor however staff #2 indicated that staff #2 comforted child #1 because child #1 was crying.

Later, the parent called and informed the facility that child #1 was taken to the doctor and received minor medical treatment for an elbow injury. The child returned to school two days later with no restrictions. On April 6, 2023 LPA observed the child playing and conducting normal school activities.

Based on video and staff disclosure, LPA could not substantiate that a Title 22 violation occurred.

Staff followed the required protocol in terms of "reporting requirements" as the 3/29/2023 incident was reported to Child Care Licensing within the required 24 hours. Information provided matches the incident report. There were no corroborated disclosures which indicate that a Title 22 violation occurred regarding this incident.

The Notice of Site Visit (LIC 9213)must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Site Supervisor Ariana Chavez.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2023
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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