191606208-11-20-2019-54-CC-BVON-BKXB2S-20200117234157

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191606208
Report Date: 11/20/2019
Date Signed: 11/20/2019 02:59:18 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
10/15/2019 and conducted by Evaluator Armando J Lucero

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20191015112448

FACILITY NAME:	EMERSON STATE PRESCHOOL		FACILITY NUMBER:	191606208
ADMINISTRATOR:	SYDNEY RITCHEY-BURNETT		FACILITY TYPE:	850
ADDRESS:	1011 E. CALDWELL STREET		TELEPHONE:	(310) 898-6173
CITY:	COMPTON	STATE: CA	ZIP CODE:	90221
CAPACITY:	48	CENSUS: 19	DATE:	11/20/2019
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Graciela Curiel, Teacher		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff failed to keep facility free from pest.

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analysts (LPAs) A. Lucero and A. Gontarek regarding the allegation above. LPAs met with Teacher Graciela Curiel.

Complaint alleges staff failed to keep facility free from pest. Interviews were conducted with school staff. Per disclosures made by staff during interviews conducted, records obtained, and observations made by LPA, it was determined that the facility has pests.

Based on the LPAs observations, interviews concluded and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22 101238(a)(1) Buildings and Grounds, is being cited on the attached LIC 9099-D.

Report Continues on Next Page

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

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 54-CC-20191015112448

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: EMERSON STATE PRESCHOOL	FACILITY NUMBER: 191606208
	VISIT DATE: 11/20/2019

NARRATIVE

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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.

Exit interview conducted with the Licensee, during which appeal rights were given and explained. A copy of the Appeal Rights (LIC 9058 01/16) was provided. The Licensee’s signature on this report acknowledges receipt of rights.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

LIC9099 (FAS) - (06/04)

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Control Number 54-CC-20191015112448

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: EMERSON STATE PRESCHOOL	FACILITY NUMBER: 191606208
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/20/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/20/2019 Section Cited CCR 101238(a)(1)	1 2 3 4 5 6 7	Buildings and Grounds The licensee shall take measures to keep the center free of flies, other insects, and rodents. The requirement is not met as evidenced by: During interviews conducted and information	1 2 3 4 5 6 7	A maintenance request submitted on 10/21/2019 was completed on 10/30/2019 for pests in preschool classrooms.
	8 9 10 11 12 13 14	obtained, it was determined that the facility had pests. This is a potential risk 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: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

LIC9099 (FAS) - (06/04)

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