191602005-12-9-2021-54-CC-KCHS-CB937J-20220201170001

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191602005
Report Date: 12/09/2021
Date Signed: 12/09/2021 03:34:00 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 CENTER DR 200B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/05/2021 and conducted by Evaluator Warren Birks

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20211005121529

FACILITY NAME:	LAKEWOOD VILLAGE COMMUNITY CHURCH NURSERY SCHOOL		FACILITY NUMBER:	191602005
ADMINISTRATOR:	MARIE TUSCANY		FACILITY TYPE:	850
ADDRESS:	4919 CENTRALIA		TELEPHONE:	(562) 421-4486
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	84	CENSUS: 71	DATE:	12/09/2021
		UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Sue Dickson		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Child handled roughly by staff.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced complaint inspection to deliver a finding for the above allegation. LPA met with Director Sue Dickson who assisted with the investigation.

During the course of the investigation, LPA conducted interviews with five (5) staff. LPA also conducted interviews with six (6) children including the alleged victim. One child of six was qualified to interview. LPA received no disclosures from children or staff indicating that they witnessed the allegation or witnessed behavior indicative of the allegation. LPA received no information that corroborates the allegation. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, at this time the above allegation is Unsubstantiated.

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. Failure to maintain posting as required will result in a civil penalty of $100.00.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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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