191670722-12-9-2022-54-CC-TCON-CMJS75-20221228123659

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191670722
Report Date: 12/09/2022
Date Signed: 12/09/2022 10:39:32 AM

Substantiated

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
10/26/2022 and conducted by Evaluator Katrina Chicote

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20221026083420

FACILITY NAME:	LBUSD-GRANT CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191670722
ADMINISTRATOR:	KIMBERLY KELLY		FACILITY TYPE:	850
ADDRESS:	6405 WALNUT AVE		TELEPHONE:	(562) 422-4686
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	95	CENSUS: 31	DATE:	12/09/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kimberly Kelly, Site Supervisor		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Other - Child was inappropriately touched by another child in care.

INVESTIGATION FINDINGS:

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On 12/09/2022 at 9:10 AM, LPA met with Kimberly Kelly, Site Supevisor, for the purpose of an unannounced complaint investigation to delivering findings to the above allegation. LPA disclosed purpose of visit to Site Supervisor and was granted access to the facility. LPA observed carpets being cleaned by cleaning crew upon arrival. LPA observed 31 preschoolers with six staff members playing outside at time of inspection.

During the course of investigation, LPA obtained pertinent documents, made observations, and interviewed staff, children, and parents. A1, staff member that was supervising children in the restroom at the time, confirm that alleged incident occurred and that she provided immediate assistance to the child after, though she did not observe the incident when it occurred. LPA reviewed Staff Handbook and did not observe written directive on Bathroom Policy supevision procedures. Interview with Administrators state they have reviewed and updated their supervision policies with staff and provided resources to families involved as a response to the incident.
Report Continues - Page 1 of 2

Substantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022

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-20221026083420

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: LBUSD-GRANT CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670722
	VISIT DATE: 12/09/2022

NARRATIVE

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Interviews with parents who have children attending the facility stated that they are not aware of bathroom policy but are satisfied with level of care provided and did not express any concerns in regards to supervision at the facility.

Based on the available information obtained by interviews conducted, record review, and LPA observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated.

The following citations are being cited today on the attached LIC 9099D.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Kimberly Kelly.

Report Ends - Page 2 of 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 54-CC-20221026083420

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: LBUSD-GRANT CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191670722
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/12/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 (a)(1) Responsibility for Providing Care and Supervision The licensee shall provide.. supervision.. to meet the children's needs.. No child(ren) shall be left without the supervision.. at any time,... include visual observation. This regualtion was not met as evidenced by:	1 2 3 4 5 6 7	Facility Representative states they will update Staff Handbook and provide adendum and have teachers signatures confirming all have recieved udpated guidance by POC date. Site Supersvisor provided written declaration with updated bathroom policy procedures at time of inspection.
	8 9 10 11 12 13 14	Based on LPA interviews and record review Licensee did not provide adequate supervision to children in bathroom by A1 leaving bathroom to open entrance. LPA did not observe bathroom policy supervision procedures in staff handbook. This is an immediate health, safety, and personal rights 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
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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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022

LIC9099 (FAS) - (06/04)

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