191500469-6-4-2021-33-CC-CGUA-C3NW4F-20210604165729

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191500469
Report Date: 06/04/2021
Date Signed: 06/04/2021 03:37:14 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
03/09/2021 and conducted by Evaluator Seung Lee

COMPLAINT CONTROL NUMBER: 33-CC-20210309164029

FACILITY NAME:	MARYVALE DAY CARE CENTER		FACILITY NUMBER:	191500469
ADMINISTRATOR:	JESSICA LIRA		FACILITY TYPE:	850
ADDRESS:	7600 EAST GRAVES AVENUE		TELEPHONE:	(626) 280-6510
CITY:	ROSEMEAD	STATE: CA	ZIP CODE:	91770
CAPACITY:	60	CENSUS: 33	DATE:	06/04/2021
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Christina Moore		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not supervise child properly

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Seung Lee contacted the facility via telephone to initiate the 10-day complaint investigation due to COVID-19 and pre-cautionary measures. LPA Lee identified himself and spoke to facility representative Christina Moore and discussed the purpose of the call.

During the course of the investigation, LPA conducted interviews, reviewed records, and made observations in regards to the above allegation.

The complaint alleges that the facility is not providing adequate supervision resulting in incidents between children in the classroom. The complaint specified that Child#1 is often aggressive towards other children and staff members in the classroom. The facility denied this allegation and made no disclosure. The facility does have a policty regarding diciplien procedures for children being aggressive towards other children. While it is possible that the facility is not properly following its own procedure regarding dicipline and supervision, the fact that two children are involved in an incident does not prove this is the case.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

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 2

Control Number 33-CC-20210309164029

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: MARYVALE DAY CARE CENTER	FACILITY NUMBER: 191500469
	VISIT DATE: 06/04/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

It is possible that an incident involving child on child aggression occurred in a classroom even if a staff member observed the incident while providing adequate supervision. A staff member might be not be able to prevent an incident in the classroom due to not being physically close enough to prevent the incident . It is possible that staff members of this facility did not follow proper protocol which resulted in preventable incidents, but there was not enough evidence to prove this was the case.

This department has investigated the allegation that facility did not supervise children properly. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated at this time.

An exit phone interview has been conducted with facility representative Christina Moore. Appeal Rights were verbally explained to Licensee as well. A copy of this report has been signed by LPA Seung Lee. This report along with appeal Rights will be scanned via e-mail to facility representative Christina Moore who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report, and the Appeal Rights has been placed in today’s mail and facility representative Christina Moore agrees to sign the bottom of each page of the 9099 and return the originals to LPA Lee in-person or via U.S. Mail.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2