191590008-9-22-2021-33-CC-BVON-C8N4LF-20211110181151

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191590008
Report Date: 09/22/2021
Date Signed: 09/22/2021 02:47:01 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
08/30/2021 and conducted by Evaluator Thelma Razo

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20210830141958

FACILITY NAME:	CHARTER OAK DAY SCHOOL		FACILITY NUMBER:	191590008
ADMINISTRATOR:	GOFRAN, ELANA		FACILITY TYPE:	850
ADDRESS:	20350 E. CIENEGA AVE.		TELEPHONE:	(626) 967-6611
CITY:	COVINA	STATE: CA	ZIP CODE:	91724
CAPACITY:	42	CENSUS: 24	DATE:	09/22/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Viviann Ivory, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff are not taking any precautions for COVID-19 and are not practicing social distancing.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Thelma Razo and LPA Steven Tung conducted a subsequent complaint visit to deliver findings on the allegation that facility staff are not taking any precautions for COVID-19 and are not practicing social distancing.. LPA met with Licensee Viviann Ivory and stated the purpose of the visit.

On 9/2/2021, LPA Razo toured the preschool facility, interviewed 4 children and 3 staff. LPA obtained Children List Report (with chiild's name, class, program and birth date), Protocol in Lieu of COVID-19, 3 email notifications to parents/authorized representative regarding COVID-19 exposures and updates, and copy of Order from Daltex Sanitizing and Deep Cleaning dated 8/1/2021. On 9/10/2021, LPA interviewed 2 parents by phone.

Per Administrator Viviann Ivory, the school has a COVID-19 protocol in line with the Los Angeles County Department of Public Health's guidelines which includes wearing face coverings, having a stable cohort, routine cleaning and disinfecting, hand washing, 6 feet physical distancing, etc. A review of the written "Protocol in Lieu of COVID-19" has validated Ms. Ivory's statement. Various interviews have indicated that

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

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-20210830141958

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: CHARTER OAK DAY SCHOOL	FACILITY NUMBER: 191590008
	VISIT DATE: 09/22/2021

NARRATIVE

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staff are required to wear mask and children are encouraged to wear masks. Per interviews, each child has a designated area for spacing and staff implement COVID-19 protocol such as wellness check, hand washing, temperature check and social distancing. Interviews have indicated that Staff #1 who provided coverage was tested positive on 7/30/21 and Staff#2 was tested positive on 8/4/2021. Both staff had no known direct contact with each other and had immediately self-quarantined for about 14 days after learning the positive test result. According to Administrator Viviann Ivory, on 8/1/2021, a professional cleaning crew (Daltex) came to sanitize the daycare, and an email was sent out to notify the parents/authorized representative of the COVID-19 positive diagnosis. The daycare was closed on 8/4/2021 and resumed operation on 8/23/2021. Per interviews, there were no reported COVID-19 cases with children.
During the facility tour on 9/2/2021, LPA observed signs at the center entrance requiring face covering per CDC guidelines, social distancing (6 feet), and hand cleaning/sanitizing. There was also a sign outside of the staff lounge that allows only one staff at a time in the area. LPA observed staff and children were wearing masks except when children were napping. Each child has a picture on the table which were spaced out, and hand washing supplies were observed on each sink.
Based on the information gathered, interviews and observation, there were no evidence to support the allegation. Although the allegation may have 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

No deficiencies were cited per California Code of Regulation Title 22 Division 12.

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 held, copy of reports and Appeal Rights provided.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma Razo	TELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

LIC9099 (FAS) - (06/04)

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