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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020745
Report Date: 11/21/2024
Date Signed: 11/21/2024 10:43:36 AM

Document Has Been Signed on 11/21/2024 10:43 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LITTLE SEED CHILD DEVELOPMENT CENTERFACILITY NUMBER:
198020745
ADMINISTRATOR/
DIRECTOR:		MA, BOFACILITY TYPE:
850
ADDRESS:630 N. RODEO WAYTELEPHONE:
(626) 551-8228
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 119TOTAL ENROLLED CHILDREN: 105CENSUS: 91DATE:
11/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Anqi Zhang, Assistant DirectorTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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On 11/21/2024, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management visit. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with Anqi Zhang, Assistant Director and explained the purpose of the visit. There were 91 children with 15 staff members present in 6 different classrooms.

The purpose of this visit is to deliver investigation finding for an incident that occurred on 10/21/2024 which was reported to the department on 10/22/2024. The self-reported incident is regarding personal rights.

During the course of the investigation, LPA toured the area of the incident, interviewed Staff #1 (S1) and Staff #2 (S2) and obtained/reviewed a copy of video footage and photos of the incident.

On the day of the incident, a classroom door closed on C1’s finger causing injury to the finger. Per interviews with S1 and S2, who were both present at time of the incident, stated that children were dropped off via side door of the classroom. S2 opened the side door to allow children in the classroom. After children entered the classroom, S2 closed the door and did not notice C1 behind the door. C1’s finger was caught on the hinge side of the door. LPA view video footage and observed the chain of events and interviews with Staff are consistent. Video footage reviewed showed that although sufficient staff was present, children entering the classroom congregated near the doorway rather than being escorted away from the entrance. The injury to the child required medical attention.

Based on the facts of the incident, this incident could have been prevented. The deficiency was cited in accordance with the Title 22 of the California Code of Regulations and Health & Safety Codes. Please see LIC809D page for documentation of deficiency.

An exit Interview was conducted, a copy of this report and appeal rights along with Notice of Site visit was provided to the Assistant Director. Notice of Site visit must be posted for 30 days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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Document Has Been Signed on 11/21/2024 10:43 AM - It Cannot Be Edited


Created By: Kruz Long On 11/21/2024 at 10:30 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LITTLE SEED CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 198020745

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/05/2024
Section Cited
CCR
101223(a)

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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Licensee will provide a plan to ensure that incidents of this nature will be prevented in the future. Copy of the plan shall be provide to the department by the POC date.
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This requirement is not met as evidenced by:
Classroom door closed on C1’s finger causing injury to the finger.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Kruz Long
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2024


LIC809 (FAS) - (06/04)
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