Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191871500
Report Date: 05/15/2015 12:00:00 AM
Date Signed 05/15/2015 12:48:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:F.K.C. PRICE III, CHILD CARE CTRFACILITY NUMBER:
191871500
ADMINISTRATOR:KRISTINA MITCHELLFACILITY TYPE:
850
ADDRESS:7901 SO. VERMONT AVE.TELEPHONE:
(323) 758-3777
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:80CENSUS: 28DATE:
05/15/2015
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Kristina Mitchell, DirectorTIME COMPLETED:
01:00 PM
NARRATIVE
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LPA Sharalyn Jenkins-Sweeten conducted this case management visit for the purpose of citing deficiencies observed during a separate case management visit at the facility. While touring the facility to obtain a head count of all preschool children present in the facility, LPA observed a 2 year female child left alone standing in the bathroom. Approximately three minutes prior, the LPA observed the 2 year old classroom teacher and children assembling in the activity room with the 4 year old preschool children, which is across the play yard, nearest the entrance and next to the director's office. The LPA brought the child to the director and the child was immediately reunited with staff.

The deficiencies observed were a lack of supervision and a violation of the child's personal rights. The deficiencies have been cited and an immediate civil penalty has been assessed.

Upon receipt, licensee shall post the report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Note: Repeated violations within 12 months will be assessed a civil penalty.

This matter may result in a Non-Compliance or Supervisory Conference with management of the Los Angeles North West Child Care Office. A copy of this report was explained and issued to the director, Kristina Mitchell.
SUPERVISOR'S NAME: Bill MayedaTELEPHONE: (310) 337-4341
LICENSING EVALUATOR NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)568-2448
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2015
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: F.K.C. PRICE III, CHILD CARE CTR
FACILITY NUMBER: 191871500
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2015
Section Cited
101229(a)(1)
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Care and Supervision. LPA observed a child left alone in a classroom with no adult supervision. Per Title 22 Regulations, no child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1). *$150 Immediate Civil Penalty Assessed*
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The licensee shall immediately ensure all children are supervised at all times. The licensee shall conduct training on supervision of children in the child care setting with all staff and submit proof of training via the attendance sheet, training materials and presenters contact information no later than 5/26/15.
Type A
05/26/2015
Section Cited
101223(a)(2)
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Personal Rights. LPA observed a child left alone in a classroom with no adult supervision. Per Title 22 Regulations, each child shall be accorded safe, healthful and comfortable accommodations, furnishings and equipment.
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The licensee shall provide a written declaration outlining procedures to be implemented by staff to provide adequate supervision to children in care at all times no later than 5/26/2015.
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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: Bill MayedaTELEPHONE: (310) 337-4341
LICENSING EVALUATOR NAME: Sharalyn Jenkins-SweetenTELEPHONE: (310)568-2448
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2015
LIC809 (FAS) - (06/04)
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