191598992-9-8-2021-33-CC-CGAN-C7HUSH-20211005155019

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191598992
Report Date: 09/08/2021
Date Signed: 09/08/2021 10:52:54 AM

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
07/19/2021 and conducted by Evaluator Nolan Tcheng

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20210719104249

FACILITY NAME:	KATHY KREDEL NURSERY SCHOOL		FACILITY NUMBER:	191598992
ADMINISTRATOR:	GWEN BLACKMON		FACILITY TYPE:	830
ADDRESS:	300 W. HUNTINGTON DRIVE		TELEPHONE:	(626) 574-3524
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	55	CENSUS: 21	DATE:	09/08/2021
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Gwen Blackmon - Director		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Staff do not provide adequate supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced in person inspection to deliver complaint findings for the above allegation. Upon arrival at 9:45am, LPA was met by Director Gwen Blackmon, to whom the purpose of the inspection was provided. LPA was provided a tour of the facility at 9:50am.

Census was taken. There were 2 children and 1 staff in Infant #2, 4 children and 2 staff in Infant #3, 7 children and 2 staff in Toddler Room, and 8 children and 2 staff in Green Room.

Throughout the course of the investigation, interviews were conducted with the complainant, three staff members, and six parents. Documentation in the form of Child Care Facility Roster, Copy of Staff Written Statement, and Pictures regarding the allegation were obtained.

REPORT CONTINUES PAGE 1 of 2.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

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 3

Control Number 33-CC-20210719104249

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: KATHY KREDEL NURSERY SCHOOL	FACILITY NUMBER: 191598992
	VISIT DATE: 09/08/2021

NARRATIVE

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Information from the complainant is regarding concern of supervision at the facility to keep children in care safe. The concern comes from Child #1 sustaining multiple injuries in a ten day span.

Director states that Teacher-child ratio is always maintained for supervising children during outdoor play.

Children were unable to be interviewed during course of investigation due to nonverbal age.

Staff interviews revealed that Staff #3 did not observed Child #1 fall off the slide. Staff interviews disclosed that the infant classrooms go outside together and that staff assist each other in watching after each other’s infants. Staff were all present in the outdoor area during the time of the incident. Per Staff #3, they saw Child #1 going up the little slide. They stated that they need to watch all the children in care while outside with the other classrooms. When they looked, they saw Child #1 on their side on the ground and immediately responded to care for him. A written statement regarding the incident, provided to licensing staff, supports the information stated in staff interview.

Parent interviews did not make any disclosures regarding the above allegation.

Based on LPAs observations and interviews which were conducted and record review, 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 1 101429), are being cited on the attached deficiencies page.

Please refer to attached 9099D for documentation of deficiencies.

Exit interview was conducted with Director Gwen Blackmon, 10:40am , including, but not limited to Provider Rights, Appeal Procedures and Agency’s Consultative Role.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

END OF REPORT PAGE 2 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20210719104249

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: KATHY KREDEL NURSERY SCHOOL	FACILITY NUMBER: 191598992
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/08/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/22/2021 Section Cited CCR 101429(a)(1)	1 2 3 4 5 6 7	101429(a)(1) Responsibility for Providing Care and Supervision to Infants Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Per Director, they will submit a schedule noting each infant classroom will have their own outside time separate from other classrooms. Staff will watch ccld.childcarevideos.org regarding Supervising Children in CHild Care Centers and submit summaries by POC
	8 9 10 11 12 13 14	Based on interview, Licensee did not ensure that Child #1 was under direct visual supervision at all times, resulting in child sustaning injury while in care. This poses a potential risk to the health, safety, and personal rights to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

LIC9099 (FAS) - (06/04)

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