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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191800316
Report Date: 03/06/2024
Date Signed: 03/06/2024 03:06:03 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 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
01/09/2024 and conducted by Evaluator Tiffanie Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20240109160823
FACILITY NAME:ONE HUNDRED TWELFTH STREET EARLY EDUCATIONFACILITY NUMBER:
191800316
ADMINISTRATOR:VERNIDA WATSONFACILITY TYPE:
850
ADDRESS:1319 EAST 112TH STREETTELEPHONE:
(323) 567-9631
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:108CENSUS: 51DATE:
03/06/2024
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:La Shan GainesTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Personal Rights:
Staff supervised children smelling like alcohol
Staff used profanity in the presence of daycare children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), T. Tran arrived at the above licensed facility to conduct a subsequent complaint inspection for the purpose of concluding for the aforementioned allegations. LPA met with La Shan Gaines, Head Teacher and we toured the facility. LPA observe proper care and supervision.
Based on the interviews conducted, on October 20, 2023 a former staff had arrived to work smelling like alcoho and used profanity language in the presence of the daycare children. This staff is no longer working at the facilty as of November 2023. Therefore, based on the preponderance of evidence, the above allegations was substantiated. A finding means that the complaint is substantiated and the allegation is valid because the preponderance of the evidence standard has been met.
Facility was cited type B deficiencies. Please see Complaint Investigation Report LIC 9099D for deficiency cited. Plan of Correction was cleared during today's visit.
An exit interview was conducted with the licensee, and a notice of site visit was provided along with the appeal rights.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Denise GibbsTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
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 54-CC-20240109160823
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ONE HUNDRED TWELFTH STREET EARLY EDUCATION
FACILITY NUMBER: 191800316
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2024
Section Cited
CCR
101223(a)(2)
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Personal Rights
This requirement is not met as evidenced by based on interview on October 20, 2023 a former staff arrived to work smelling like alcohol which poses a potential health and safety risk to children in care.
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Per facility representative, disciplinary action was taking immediately, this staff is no longer working at the facility as of November 2023.
POC have been corrected during today visit.
Type B
03/06/2024
Section Cited
CCR
101223(a)(1)
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Personal Rights
This requirement is not met as evidenced by based on interview on October 20, 2023 a former staff was using profanity language in the presence of the children in care which poses a potential health and safety risk to children in care.
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Per facility representative, disciplinary action was taking immediately, this staff is no longer working at the facility as of November 2023.
POC have been corrected during today visit.
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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: Denise GibbsTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 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
01/09/2024 and conducted by Evaluator Tiffanie Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20240109160823

FACILITY NAME:ONE HUNDRED TWELFTH STREET EARLY EDUCATIONFACILITY NUMBER:
191800316
ADMINISTRATOR:VERNIDA WATSONFACILITY TYPE:
850
ADDRESS:1319 EAST 112TH STREETTELEPHONE:
(323) 567-9631
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:63CENSUS: 51DATE:
03/06/2024
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:La Shan GainesTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights:
Facility failed to proivde a safe and comfortable environment for children possible drug activity on the premise.
Staff handled children in a rough manner
Staff yelled at children
Staff withheld food from children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), T. Tran arrived at the above licensed facility to conduct a subsequent complaint inspection for the purpose of concluding for the aforementioned allegations. LPA met with La Shan Gaines.
Based upon the evidence obtained through the course of interviews with staff, daycare children, and other, the available interviewed parties confirmed that the children were not impacted by the above personal rights allegations. Due to insufficient evidence to support or disprove children’s personal has been violated while in care, therefore this allegation has 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.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, La Shan Gaines..
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Denise GibbsTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3