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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191601954
Report Date: 04/22/2020
Date Signed: 04/22/2020 11:52:44 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/05/2020 and conducted by Evaluator Sabrina Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20200205103329
FACILITY NAME:UCLA EARLY CARE AND EDUCATION-INFANTSFACILITY NUMBER:
191601954
ADMINISTRATOR:AMY AGNEWFACILITY TYPE:
830
ADDRESS:101 S. BELLAGIO DR.TELEPHONE:
(310) 825-5086
CITY:LOS ANGELESSTATE: CAZIP CODE:
90095
CAPACITY:60CENSUS: 0DATE:
04/22/2020
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Amy Agnew, Center DirectorTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Facility is operating out of ratio.
Facility comingles children.
Unqualified staff providing care and supervision to children in care.
INVESTIGATION FINDINGS:
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On 04/22/2020 at 11:30 am, Licensing Program Analyst (LPA) Sabrina Martinez contacted Amy Agnew, Center Director, via email, for the purpose of delivering the investigation findings for the above-mentioned allegations. Due to the recent Coronavirus (Covid-19) pandemic, UCLA Early Care and Education-Infants has decided to take a preventative, precautionary measure and close the programs until further notice. No children have been present at the facility since March 19, 2020.

Based upon the evidence obtained during the course of the investigation through staff and parent’s interviews and review of records, the evidence does not support, nor disprove the above allegations occurred at the facility. Therefore, the allegations have been determined unsubstantiated. Unsubstantiated – A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. LPA informed the Director that two hard copies of this report, and appeal rights will be mailed by certified mail to licensee/director for per COVID-19 procedures. Director is to return one signed copy to the Department and is to keep the other copy for facility records.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2020
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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