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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191594162
Report Date: 11/14/2022
Date Signed: 12/02/2022 11:19:24 AM

Substantiated


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
11/08/2022 and conducted by Evaluator Bardo Baluyot
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20221108093243
FACILITY NAME:ALMANSOR CENTER (THE)FACILITY NUMBER:
191594162
ADMINISTRATOR:TAMERA PINELOFACILITY TYPE:
850
ADDRESS:1955 FREMONT AVENUETELEPHONE:
(323) 341-7768
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY:60CENSUS: 44DATE:
11/14/2022
UNANNOUNCEDTIME BEGAN:
08:24 AM
MET WITH:Director, Tamera PineloTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Daycare child sustained injuries while in care
Staff did not provide a safe environment for child in care
INVESTIGATION FINDINGS:
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-This an amended version of the report issued to the facility on 11/14/2022.

Licensing Program Analyst (LPA) Bardo Baluyot conducted an unannounced initial complaint inspection at approximately 8:30 am. The purpose of the inspection was to investigate the above allegations. Upon arrival, LPA conducted a COVID risk self-assessment and met with Director,Tamero Pinelo who guided LPA on a tour of the facility. There were 44 children in care with 13 staff present during the inspection. LPA obtained a copy of the children's roster and conducted staff interviews.

This agency has investigated the complaint alleging that “Daycare child sustained injuries while in care" and
"Staff did not provide a safe environment for child in care". According to the allegation, the RP stated that, “While the teacher was busy with the two children, the RP’s child went to the bathroom, and climbed on the snow cone machine cart. The cart fell on the RP’s child and child sustained injuries.
Substantiated
Estimated Days of Completion: 1
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022
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 4
Control Number 33-CC-20221108093243
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: ALMANSOR CENTER (THE)
FACILITY NUMBER: 191594162
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/14/2022
Section Cited
CCR
101212(d)(1)(B)
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REPORTING REQUIREMENTS:
Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1)(B) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information
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Director will ensure that an Unusal Incident Report will be submitted within 24 hours. Director will submit a UIR immediately.

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specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. Events reported shall include the following: Any injury to any child that requires medical treatment. This requirement was not met as evidenced by staff disclosure and FAS review. The injury/incident involving the sno cone machine was not reported to licensing as required. This is a potential risk to the health and safety of children in care.
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CCR
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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: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 33-CC-20221108093243
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: ALMANSOR CENTER (THE)
FACILITY NUMBER: 191594162
VISIT DATE: 11/14/2022
NARRATIVE
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-This an amended version of the report issued to the facility on 11/14/2022.

LPA conducted interviews with RP, Director and staff and obtained consistent statements that classes were in ratio and had proper supervision. However, Per Director’s own admission, she had been out on sick leave and did not ensure the maintenance crew had returned the sno-cone machine to its designated and usual storage location. Additionally, LPA obtained photos of the child's injuries along with copies of text message correspondence between the RP and the Director involving a legal/insurance claim RP has filed against the facility where the Director references the incident report on multiple occasions. Per Director, due to the pending claim by RP, Licensee's Human Resources Representative instructed Director to not send the UIR to Licensing.

Based on photos and consistent statements obtained from interviews, this agency has investigated the complaint alleging “Daycare child sustained injuries while in care" and "Staff did not provide a safe environment for child in care" and determined that the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, (Title 22, Division 12 & Chapter Number 1), are being cited on the attached LIC 9099D. Two deficiencies were cited during today’s visit.

Upon receipt, the Licensee shall post the “D” page of the Licensing report. This page shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100 civil penalty. A copy of this report shall be provided to the parents/guardians of the children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parents/guardians of any children newly enrolled at the facility for the next 12 months. The LIC 9224 Acknowledgement of Receipt of Licensing Reports must be maintained in each child's file immediately upon receipt from the parent. LPA provided Director with a blank copy of the LIC 9224 Acknowledgement of Receipt of Licensing Report.



An exit interview was conducted with Director, Tammie Pinelo and a copy of this report was provided and signed by LPA Bardo Baluyot. The notice of site visit must be 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.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 33-CC-20221108093243
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: ALMANSOR CENTER (THE)
FACILITY NUMBER: 191594162
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/14/2022
Section Cited
CCR
101223(a)(2)
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Personal Rights.

The licensee shall ensure that each child is accorded the following personal rights:
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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The sno-cone machine was immediately removed from classroom and made inaccesible to children.
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This requirement was not met as evidenced by Director's own admission that the sno-cone machine was not stored adequately and was accesible to the child causing injury. This is a potential 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: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4