LETTERMAN DIGITAL ARTS CCC (PRESCHOOL)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection today. LPA met with the Site Director, Vicky Patel, and Assistant Site Director, Sherri Irving, and explained the purpose of the inspection to them. There were 54 children with 20 staff present. The facility self reported an unusual incident report on 1/12/23 regarding a staff handled a child inappropriately that caused a child was injured. LPA interviewed witness during the inspection. Based on the interviews and relevant document gathered by LPA, there was the sufficient evidence to prove a staff handled a child inappropriately that ended up a child was injured. *Please see next page for deficiency cited under CCR, Title 22, Div. 12, Chapter 1: An exit inspection was conducted with the Site Director and appeal rights were explained. A printed copy of the report, as well as a printed copy of the appeal rights, were provided to the Licensee at the conclusion of the inspection. Notice of site visit was posted and must remain posted for 30 days for public review. SUPERVISORS NAME: Garfield Leung LICENSING EVALUATOR NAME: Cindy Mok LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023 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: LETTERMAN DIGITAL ARTS CCC (PRESCHOOL) FACILITY NUMBER: 384001491 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 01/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 01/24/2023 Section Cited CCR 101223(a)(2) 1 2 3 4 5 6 7101223 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. 1 2 3 4 5 6 7The licensee must set up a plan to prevent the same or similar incident happening in the facility and submit the plan to CCL by the due date 1/24/2023. 8 9 10 11 12 13 14This requirement was not met as evidence-based upon interviews and relevant document; a child was injured due to a staff handled inappropriately. This poses a potential health risk to children in care. 8 9 10 11 12 13 14 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:Garfield Leung LICENSING EVALUATOR NAME:Cindy Mok LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection today. LPA met with the Site Director, Vicky Patel, and Assistant Site Director, Sherri Irving, and explained the purpose of the inspection to them. There were 54 children with 20 staff present. The facility self reported an unusual incident report on 1/12/23 regarding a staff handled a child inappropriately that caused a child was injured. LPA interviewed witness during the inspection. Based on the interviews and relevant document gathered by LPA, there was the sufficient evidence to prove a staff handled a child inappropriately that ended up a child was injured. *Please see next page for deficiency cited under CCR, Title 22, Div. 12, Chapter 1: An exit inspection was conducted with the Site Director and appeal rights were explained. A printed copy of the report, as well as a printed copy of the appeal rights, were provided to the Licensee at the conclusion of the inspection. Notice of site visit was posted and must remain posted for 30 days for public review. SUPERVISORS NAME: Garfield Leung LICENSING EVALUATOR NAME: Cindy Mok LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023 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: LETTERMAN DIGITAL ARTS CCC (PRESCHOOL) FACILITY NUMBER: 384001491 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 01/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 01/24/2023 Section Cited CCR 101223(a)(2) 1 2 3 4 5 6 7101223 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. 1 2 3 4 5 6 7The licensee must set up a plan to prevent the same or similar incident happening in the facility and submit the plan to CCL by the due date 1/24/2023. 8 9 10 11 12 13 14This requirement was not met as evidence-based upon interviews and relevant document; a child was injured due to a staff handled inappropriately. This poses a potential health risk to children in care. 8 9 10 11 12 13 14 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:Garfield Leung LICENSING EVALUATOR NAME:Cindy Mok LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023

Type B citation - potential risk if not corrected