191606802-1-27-2022-30-CC-MNEL-CCRPDX-20220322111414

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191606802
Report Date: 01/27/2022
Date Signed: 01/27/2022 11:05:24 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
01/21/2022 and conducted by Evaluator Miriam Cohen

COMPLAINT CONTROL NUMBER: 30-CC-20220121080132

FACILITY NAME:	CHILD LANE		FACILITY NUMBER:	191606802
ADMINISTRATOR:	ROBERTA RAMIREZ		FACILITY TYPE:	850
ADDRESS:	769 W. 3RD STREET		TELEPHONE:	(310) 514-4999
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90731
CAPACITY:	62	CENSUS: 42	DATE:	01/27/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Roberta Ramirez, Director		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

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Facility failed to meet reporting requirements

INVESTIGATION FINDINGS:

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On 01/27/2022 @ 9:00 AM, Licensing Program Analyst (LPA) Miriam Cohen conducted an unannounced complaint visit for the purpose of notifying the preschool director concerning the above-mentioned allegation and to perform an investigation. Upon arrival, LPA Cohen observed 12 adults providing care for 42 children. LPA Cohen met with preschool director, Roberta Ramirez. LPA interviewed the director and obtained the following documentation:
Written declaration regarding the above allegation and a copy of current Mandated reporting certification

During the interview, Ms. Ramirez stated the following:
1. Staff member #1 (S1) verbally reported the incident to preschool director in the later afternoon of 01/10/22.
2. Police department called the facility and left a message on director’s voicemail regarding a Suspected Child Abuse Report (SCAR) involving a child that attends the above facility
3. Director acknowledged that the facility failed to meet reporting requirement

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Miriam Cohen	TELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022

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 3

Control Number 30-CC-20220121080132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHILD LANE	FACILITY NUMBER: 191606802
	VISIT DATE: 01/27/2022

NARRATIVE

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LPA Cohen substantiated the allegation based on the interview and declarative statement from the director. The facility was cited a Type B violation. An exit interview and a copy of this report was provided to the director, Roberta Ramirez.

SUBSTANTIATED - A finding that a complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Miriam Cohen	TELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 30-CC-20220121080132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHILD LANE	FACILITY NUMBER: 191606802
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/27/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/11/2022 Section Cited CCR 101212(d)(1)(D)	1 2 3 4 5 6 7	Reporting Requirements (d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) 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	1 2 3 4 5 6 7	1) The director agrees to view training and educational resources pertaining to Child Care Reporting Requirements. LPA recommendation: The Child Care Videos for Providers and Parents found on The California Child Care Licensing 2) Director agrees to provide a written summary of the video training and submit to
	8 9 10 11 12 13 14	report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following: (D) Any suspected physical or psychological abuse of any child.	8 9 10 11 12 13 14	LPA by February 11, 2022.
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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: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Miriam Cohen	TELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022

LIC9099 (FAS) - (06/04)

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