ST. SEBASTIAN PRE-K

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 03/28/2022 at 1:05 PM, Licensing Program Analyst (LPA) Denise Miranda conducted an unannounced case management inspection at St Sebastian Preschool, located at 1430 Federal Ave, Los Angeles, CA 90025 for the purpose of following up on the unusual incident that was self-reported by the facility. The El Segundo Child Care Regional Office received the report on 03/14/2022. LPA met with Director Marisa Fuentes that guided LPA indoor and outdoor. According to the incident report, on 03/04/2022, child#1 was playing at the playground and fell out from the big slide. Child#1 scraped her forehead, arm and finger. Ice pack was applied, and parents were contacted immediately. Parents of the child took to the hospital and a cast was placed on child’s right arm due a fracture. During this inspection, LPA Miranda, conducted interviews and inspection at the outdoor space. LPA observed that the playground has two slides (small and large). Per Director when the incident happened the surface it was covered with sand. Director removed the sand and the surface has rubber mulch at the playground area and some area needs repair. LPA observed when Director placed a yellow tape at the playground structure, making this area inaccessible to the children in care. A declaration was obtained from Director regarding playground structure and age appropriate. Based on the available information, it appears that the incident was the result of a Title 22 violation for Fixtures, Furniture, Equipment and Supplies. acility was cited a Type B violation today, 03/28/2022 (See LIC 809-D for deficiency cited.) An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit was provided to Marisa Fuentes, Director. SUPERVISORS NAME: Claudia Escobedo LICENSING EVALUATOR NAME: Denise Miranda LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2022 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: ST. SEBASTIAN PRE-K FACILITY NUMBER: 197412885 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/28/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/12/2022 Section Cited CCR 101239(m) 1 2 3 4 5 6 7(m) All play equipment and materials used by children shall be age-appropriate. During inspection, LPA observed that Playgroung does not have age appropriate label or manual available. 1 2 3 4 5 6 7LPA observed Director, to placed a yellow tape at the PLayground area and making inacessible to the chidlren in care. Director, provided a declaration regarding playground. 8 9 10 11 12 13 148 9 10 11 12 13 14Director agreed to have playground inspector to determine the age appropriate of the equipment and a label shall be place at the equip. Documents will be provide via email to LPA Miranda no later than 4/12/22 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Claudia Escobedo LICENSING EVALUATOR NAME:Denise Miranda LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2022

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 03/28/2022 at 1:05 PM, Licensing Program Analyst (LPA) Denise Miranda conducted an unannounced case management inspection at St Sebastian Preschool, located at 1430 Federal Ave, Los Angeles, CA 90025 for the purpose of following up on the unusual incident that was self-reported by the facility. The El Segundo Child Care Regional Office received the report on 03/14/2022. LPA met with Director Marisa Fuentes that guided LPA indoor and outdoor. According to the incident report, on 03/04/2022, child#1 was playing at the playground and fell out from the big slide. Child#1 scraped her forehead, arm and finger. Ice pack was applied, and parents were contacted immediately. Parents of the child took to the hospital and a cast was placed on child’s right arm due a fracture. During this inspection, LPA Miranda, conducted interviews and inspection at the outdoor space. LPA observed that the playground has two slides (small and large). Per Director when the incident happened the surface it was covered with sand. Director removed the sand and the surface has rubber mulch at the playground area and some area needs repair. LPA observed when Director placed a yellow tape at the playground structure, making this area inaccessible to the children in care. A declaration was obtained from Director regarding playground structure and age appropriate. Based on the available information, it appears that the incident was the result of a Title 22 violation for Fixtures, Furniture, Equipment and Supplies. acility was cited a Type B violation today, 03/28/2022 (See LIC 809-D for deficiency cited.) An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit was provided to Marisa Fuentes, Director. SUPERVISORS NAME: Claudia Escobedo LICENSING EVALUATOR NAME: Denise Miranda LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2022 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: ST. SEBASTIAN PRE-K FACILITY NUMBER: 197412885 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/28/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 04/12/2022 Section Cited CCR 101239(m) 1 2 3 4 5 6 7(m) All play equipment and materials used by children shall be age-appropriate. During inspection, LPA observed that Playgroung does not have age appropriate label or manual available. 1 2 3 4 5 6 7LPA observed Director, to placed a yellow tape at the PLayground area and making inacessible to the chidlren in care. Director, provided a declaration regarding playground. 8 9 10 11 12 13 148 9 10 11 12 13 14Director agreed to have playground inspector to determine the age appropriate of the equipment and a label shall be place at the equip. Documents will be provide via email to LPA Miranda no later than 4/12/22 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Claudia Escobedo LICENSING EVALUATOR NAME:Denise Miranda LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2022 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2022

Type B citation - potential risk if not corrected