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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191502312
Report Date: 05/22/2019
Date Signed: 05/22/2019 03:08:07 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
05/20/2019 and conducted by Evaluator Ana Chico
COMPLAINT CONTROL NUMBER: 33-CC-20190520143822
FACILITY NAME:UNITED METHODIST PRESCHOOLFACILITY NUMBER:
191502312
ADMINISTRATOR:KIM GARDNERFACILITY TYPE:
850
ADDRESS:201 E. BENNETTTELEPHONE:
(626) 335-4622
CITY:GLENDORASTATE: CAZIP CODE:
91741
CAPACITY:60CENSUS: 25DATE:
05/22/2019
UNANNOUNCEDTIME BEGAN:
01:16 PM
MET WITH:Laurene HerreraTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility is not operating within their license
INVESTIGATION FINDINGS:
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Ana Chico, Licensing Program Analyst (LPA) conducted an unannounced complaint inspection. LPA met with Laurene Herrera, Director, who guided LPA on a tour of the facility. LPA explained that the purpose for the inspection is to investigate an allegation that the facility was over capacity on one or more occasions. During the course of the investigation, LPA interviewed director who was forthcoming about having been over capacity by two children. After reviewing the sign in books for four classroom on specific and randomly selected dates, LPA found that the licensee was indeed over capacity by one child on 5/15/19. According to Director, she recalls allowing one or two additional children attend as there was a family emergency. Other randomly selected days did not find that the licensee was operating beyond the terms of the license. Based on a review of records and staff's own submission, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 Section 101116(a) is being cited on the attached LIC 9099D. A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty.

*****Report continues on an LIC 9099C..
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
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-20190520143822
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: UNITED METHODIST PRESCHOOL
FACILITY NUMBER: 191502312
VISIT DATE: 05/22/2019
NARRATIVE
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A copy of this report documenting a Type A citation shall be provided the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. Exit interview conducted with director. Appeal rights provided and explained.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20190520143822
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: UNITED METHODIST PRESCHOOL
FACILITY NUMBER: 191502312
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/22/2019
Section Cited
CCR
101116(a)
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Limitations on Capacity and Ambulatory Status: A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement has not been met as evidenced by staff's own submission that she was over capacity and a review of the sign in books.
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Director stated that she will no longer accept children when she is operating at the licensed capacity. A written statement was provided during the inspection.
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 This poses a immediate risk to the health and safety of 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: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3