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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011564
Report Date: 02/17/2023
Date Signed: 02/17/2023 04:15:01 PM

Document Has Been Signed on 02/17/2023 04:15 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:SANDERS & POPE FAMILY CHILD CAREFACILITY NUMBER:
198011564
ADMINISTRATOR:LAURIE S. & SHAQUINTA P.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 594-1116
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
02/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Licensee Laurie SandersTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Austin Estrada conducted a Case Management inspection. This inspection is to follow up on an Unusual Incident Report (UIR) that was received by Monterey Park South West Child Care Regional Office on 2/7/23 regarding a child sustaining an injury that required medical attention. LPA met with Licensee Lauire sanders and informed her of the purpose for the visit. Licensee guided LPA on a tour of the facility. LPA observed 8 children and 2 additional staff at the time of inspection.
Licensee guided LPA to the outdoor play area to observe where child #1 (C1) and Child #2 (C2) (C1 and C2 were not present during the visit) were injured. LPA observed the area in which C1 and C2 collided while playing “tag.” While playing tag C1 collided with C2 causing both C1 and C2 to hit each others heads. C1’s tooth cut open C2’s head causing C2’s head to bleed. C1 obtained a swollen lip due to the collision. Per interview with the Licensee, Staff #1 (S1), Child #3 (C3), child #4 (C4), and child #5 (C5) all information gathered corroborates the Unusual Incident Report in which this report is regarding. LPA observed the outdoor play area in which the incident occurred to be clean, orderly and free of hazards. S1 indicated they were approximately ten feet away observing the area when the incident occurred. Per Licensee and S1, children are supervised at all times while playing outside.C3, C4, C5 stated that S1 was supervising at the time of the incident.
After the incident occurred Licensee immediately called the parents of C1 and C2. Licensee and Staff #2 (S2) placed a butterfly band aid on C2’s wound. Licensee also provided an ice pack for C1 and C2 to help stop the swelling of the injuries occurred. LPA obtained the facility roster upon request.
Staff followed the required protocol in terms of first aid and "reporting requirements" as the 2/6/23 incident was reported to Child Care Licensing within 24 hours or the next business day. The Information provided matches the incident report. Based on interviews and observations there were no violations of Title 22 requirements.
A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview was conducted and report was reviewed with Licensee Laurie Sanders. Appeal rights were discussed and provided to Licensee. LPA provided Licensee with a copy of LIC 811- Confidential Names.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Austin Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2023
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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