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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191225654
Report Date: 11/20/2019
Date Signed: 11/20/2019 04:01:15 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/17/2019 and conducted by Evaluator Francisco Pedroza
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20190917172334
FACILITY NAME:WHITE OAK KID'S WORLDFACILITY NUMBER:
191225654
ADMINISTRATOR:ASHLEY CEKOVFACILITY TYPE:
840
ADDRESS:31761 VILLAGE SCHOOL RD.TELEPHONE:
(818) 597-9226
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91301
CAPACITY:90CENSUS: 30DATE:
11/20/2019
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Elizabeth BurciagoTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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9
License - Ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced inspection to conclude a complaint investigation. LPA met with Site Supervisor Elizabeth Burciago and advised her the purpose of the inspection. LPA and Site Supervisor together toured the facility inside and out. There was 30 children in care with three staff supervising the children at the time of the inspection.

Allegation stated the facility was not properly supervising children in care by staff to child ratio. LPA made two unannounced visits and toured the facility on each visit. LPA observed 29 children with two staff supervising during one inspection. The faciltiy was out of staff to child ratio by one child. Faciltiy staff contaced their headquarters at around 2:05 pm and advised they required another staff to be in ratio prior to LPA arriving. The third staff arrived seven minutes after the LPA did at approximately 2:22 pm. Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC 9099D. Appeal rights were provided to Site Supervisor.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/17/2019 and conducted by Evaluator Francisco Pedroza
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20190917172334

FACILITY NAME:WHITE OAK KID'S WORLDFACILITY NUMBER:
191225654
ADMINISTRATOR:ASHLEY CEKOVFACILITY TYPE:
840
ADDRESS:31761 VILLAGE SCHOOL RD.TELEPHONE:
(818) 597-9226
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91301
CAPACITY:90CENSUS: 30DATE:
11/20/2019
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Elizabeth BurciagoTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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2
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8
9
Qualifications - Unqualified staff supervising children in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced inspection to conclude a complaint investigation. LPA met with Site Supervisor Elizabeth Burciago and advised her the purpose of the inspection. LPA and Site Supervisor together toured the facility inside and out. There was 30 children in care with three staff supervising the children at the time of the inspection.

Allegation stated unqualified staff supervising children in care. During this investigation, LPA made two unannounced visits and toured the facility on each visit. The information gathered from LPA's observations and reviewing staff records found the facility is in compliance with regulations.

This agency has investigated the complaint regarding the above allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 17-CC-20190917172334
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: WHITE OAK KID'S WORLD
FACILITY NUMBER: 191225654
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2019
Section Cited
CCR
101516.5(b)(1)
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 Document amended from 11/20/19.
101516.5 Teacher-Child Ratio
(b) There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance.
(1) A teacher shall supervise no more than 14 children... maximum of 28 children.
This requirement is not met as evidence by:
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Licensee shall appear at the Santa Barbara Regional Office at a date and time later to be determined by the Department for an Informal Conference to discuss this deficiency citation.
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LPA observed the facility had 29 children with two staff supervising making them out of ratio by one child. A third staff was requested and in route to the facility arriving shortly after the LPA. This poses as a potential Health and Safety risk to clients / children in care.
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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: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3