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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191500117
Report Date: 12/09/2019
Date Signed: 12/09/2019 03:53:12 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
09/05/2019 and conducted by Evaluator Seung Lee
COMPLAINT CONTROL NUMBER: 33-CC-20190905144528
FACILITY NAME:CALVARY PRESCHOOLFACILITY NUMBER:
191500117
ADMINISTRATOR:MOLLY SPRAGGFACILITY TYPE:
850
ADDRESS:1050 FREMONT AVE.TELEPHONE:
(626) 799-0385
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY:134CENSUS: 69DATE:
12/09/2019
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Kristen DubeTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facilty staff hit child.
Facility staff handled daycare child roughly.
Daycare child had access to other child's food.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced complaint inspection. Upon arrival LPA Lee met with office admnistrator Kristen Dube.

During the investigation LPA Lee conducted interviews, reviewed records, and made observations in regards to the above allegations. The complaint alleges that facility staff hit and handled Child#1 in a rough manner. The complaint also alleges that Child#1 had access to another child's food which caused Child#1 to become sick at the facility. The Director and Staff members interviewed denied the allegations and made no disclosure. A review records showed that Child#1 attended the facility for one day and did not come back. The children in this preschool program bring their own sack lunches from home.

During the one day Child#1 attended, the parent of Child#1 visited the facility during lunch time and observed the child with food that was not his. Facility Staff stated that although Child#1 did have a piece of ham that was not his, he never ate it since Staff members were supervising all the Children in Child#1's table during meal time. The Director stated that Child#1's mother is the one that took the food away from Child#1 during lunch time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019
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
Control Number 33-CC-20190905144528
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: CALVARY PRESCHOOL
FACILITY NUMBER: 191500117
VISIT DATE: 12/09/2019
NARRATIVE
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During interviews, the facility staff stated that Child#1's mother was observed feeding Child#1 cheese during lunch time after she took away the other child's food away. Later on in the day, Child#1 became sick and vomited several times at the facility. The parent was contacted and arrived when Child#1 was in the restroom with a Staff member.

The reporting party of the complaint stated that it was observed that Child#1's head was pushed down into the toilet by Staff#1 as the mother of Child#1 walked into the bathroom. Staff#1 denied this allegation and made no disclosure. Staff#1 stated that the Child was simply being given assistance while vomiting. The complaint also alleges that Child#1 disclosed to his mother that Staff#1 had hit him at the facility. Although, there was no signs such as marks or bruises, Child#1 confirmed to his mother that only Staff#1 had hit him. Child#1 and his parent were not able to be reached for an interview during this investigation and could not provide further elaboration in regards to these allegations.

The facility did acknowledge that Child#1 did have possession of food that was not his for a brief moment during lunch time, but it was taken away from the Child before he could eat it. The facility stated even if the mother was not present during lunch time, the Staff sitting at the table with the children would have taken the food away. The facility alleged that the food that Child#1 was vomiting, which was cheese, was the same food that the child was being fed by his mother during meal time. The facility stated that Staff#1 who was with the Child while he was vomiting did not handle the child in a rough manner or hit him. Staff#1 was simply trying to assist the child become comfortable since he was vomiting multiple times before the Mother arrived at the facility. Child#1 had to be changed, and washed up at the sink since he had vomited multiple times before waiting in the restroom. It is possible that Child#1 did become sick from eating food that was not his due to a lack of supervision during meal time. The facility's policy of having children bring their own lunch, does require additional supervision since every child has his or her own dietary needs that can also include allergies. However, it is also possible that Child#1 became sick from eating food that was brought from home, since the Child was fed cheese by his mother and that is what was being vomited later during the day according the facility. Child#1 could have been hit earlier on during the day and handled in a rough manner by Staff#1. However, it is also possible that facility staff were just trying to get the sick child to the toilet or sink so the child does not soil his clothing or get vomit in the classroom with other children around.
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20190905144528
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: CALVARY PRESCHOOL
FACILITY NUMBER: 191500117
VISIT DATE: 12/09/2019
NARRATIVE
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Although Child#1 and his Mother were not able to be interviewed during the investigation, the reporting party did state that Child#1 had no visible marks after disclosing to his mother that he was hit at the facility. The reporting also stated that the Child stated that he had unpleasant memories of vomiting cheese at the facility. The facility stated that Child#1 was fed cheese from his home by his mother during meal time earlier in the day.

Based on the evidence collected during the investigation, the allegations that the facility staff allowed child to access another child's food, hit a child, and handled a child in a rough manner may be valid. However, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore at this time the above allegations are found to be unsubstantiated.

Exit Interview conducted with office administrator Kristen Dube. Appeal rights discussed and explained.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain this posting for 30 days will result in a civil penalty of $100.00 dollars.
SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3