Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493466
Report Date: 11/14/2018
Date Signed 11/14/2018 10:10:22 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:LITTLE GARDEN PRESCHOOL, THEFACILITY NUMBER:
197493466
ADMINISTRATOR:DOUCETTE, JOLENEFACILITY TYPE:
850
ADDRESS:2929 WASHINGTON BLVD.TELEPHONE:
(310) 694-7347
CITY:MARINA DEL REYSTATE: CAZIP CODE:
90292
CAPACITY:40CENSUS: 12DATE:
11/14/2018
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH:Jolene Doucette/licenseeTIME COMPLETED:
10:37 AM
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Licensing Program Analyst (LPA), Trevino Cochran, conducted a Case Management Incident visit to follow up on self-reported incident that occurred at Little Garden Preschool 11/6/18. The El Segundo Child Care Office received the incident report on 11/7/18 by Licensee Jolene Doucette. Report stated that on 11/6/18 a child had a seizure in the facility.

Based on today’s visit, and interviews conducted, the facility was in compliance during incident on 11/6/18. Facility staff responded immediately, provided proper cared for child, and contacted parents immediately. Although paramedics were called, no child was harmed during incident. The child was transported by paramedic to the hospital. LPA reviewed child’s file and obtained documents.

At this time based on the available information it does not appear this incident was the result of a Title 22 violation.

The content of this report was read and discussed in detail with licensee Jolene Doucette.

The facility was found to be in compliance per Title 22 regulations, Type A and B deficiencies will not be cited today 11/14/2018.

An exit interview was conducted, copy of this report, appeal rights and a notice of site visit was provided to licensee.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Trevino CochranTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2018
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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