191204677-6-29-2021-33-CC-CGAN-C5B2QS-20210726173622

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191204677
Report Date: 06/29/2021
Date Signed: 06/29/2021 01:14:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/14/2021 and conducted by Evaluator Anomeh Eivazian

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20210614140224

FACILITY NAME:	A + ADVENTIST CHILDREN'S CENTER		FACILITY NUMBER:	191204677
ADMINISTRATOR:	MALISA SMITH		FACILITY TYPE:	850
ADDRESS:	234 N. ISABEL STREET		TELEPHONE:	(818) 241-9353
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91206
CAPACITY:	78	CENSUS: 21	DATE:	06/29/2021
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Malisa Smith, Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff handled child in a rough manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Anomeh Eivazian, conducted an unannounced complaint inspection to the above facility for the purpose of delivering complaint investigation finding on 06/29/2021 at 12:15 p.m. . LPA met with Malisa Smith, facility director who guided LPA on a tour of the facility. During this inspection there were total of 21 children present in the facility.

During this investigation, LPA Eivazian conducted interviews with staff, children and random parents. A copy of facility roster was obtained. Pictures were taken from facility.

Based on interviews conducted with three random parents, and two children no disclosures were made.

Based on staff #1 interview, on 06/11/2021 child#1 was not listening to staff#1. Per staff #1 between 9:30 a.m. to 9:45 a.m on 06/11/2021, child#1 was playing with child#2 with long logs and child#1 was pointing it out towards the child#2.
REPORT CONTINUES ON NEXT PAGE 1 of 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20210614140224

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: A + ADVENTIST CHILDREN'S CENTER	FACILITY NUMBER: 191204677
	VISIT DATE: 06/29/2021

NARRATIVE

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Per staff#1, staff#1 told child#1 that this is not a proper way to play with it, then child#1 put that long log in the mouth . At this time, per staff#1, staff#1 went to child#1, hold child#1’s hand gently from arm and walked child#1 from back of the children tables towards the time out bench which is located by the entrance door in classroom. Per staff#1, staff#2 was in the classroom and saw how staff#1 put child#1 on time out.

Based on staff#2 interview, on 06/11/2021 when arrived in the classroom staff#1 told staff#2 that from the morning child#1 was not listening to staff#1. Per staff#2, staff#2 did not see what child#1 had done, however staff#2 observed staff#1 walked towards the child#1 when child#1 was in the carpet area, hold child#1’s hand from the arm gently and walked child#1 from carpet area, from back of the children tables towards the time out bench which is located by the entrance door.

Although the allegation may has happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is Unsubstantiated.

The notice of site visit was posted where the parent/guardian of children enter and exit the facility. This notice shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview was conducted with Malisa Smith, director. Appeal Rights procedures explained at 1:30 p.m.. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

REPORT END 2 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021

LIC9099 (FAS) - (06/04)

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