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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191800750
Report Date: 10/22/2020
Date Signed: 10/22/2020 04:28:16 PM



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
10/20/2020 and conducted by Evaluator Lisa Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20201020150020
FACILITY NAME:WESTSIDE JEWISH COMMUNITY PRE-SCHOOLFACILITY NUMBER:
191800750
ADMINISTRATOR:DEBORAH KAPLANFACILITY TYPE:
850
ADDRESS:5870 WEST OLYMPIC BOULEVARDTELEPHONE:
(323) 556-5251
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY:141CENSUS: DATE:
10/22/2020
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Director- Lauren FreedmanTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Conduct inimical as staff posed a direct threat to day care children in care
INVESTIGATION FINDINGS:
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On October 21, 2020, Licensing Program Analyst Lisa Rios conducted a telephone visit (due to Covid-19) regarding the allegation above.

Based on interviews conducted, documents received and statements made LPA Rios has determined that the employee in question did pose a direct threat to day care children in care. Therefore the complaint is SUBSTANTIATED,

The following deficiencies are cited per California Code Title 22 regulation 101212 (d)(1)(c), 101223 (a)(1) and an immediate Civil Penalty (see LIC9099D).


Exit interview was conducted with the Director and LPA Rios emailed a signed copy of the report and appeal rights to the Director.
Substantiated
Estimated Days of Completion: 2
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020
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 2
Control Number 30-CC-20201020150020
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: WESTSIDE JEWISH COMMUNITY PRE-SCHOOL
FACILITY NUMBER: 191800750
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/22/2020
Section Cited
CCR
101212(d)(1)(c)
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101212(d)(1)(c) ...during the operation of the child care center....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. (C) Any unusual incident...that threatens the physical or
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LPA Rios discussed with the Director anytime a staff is reprimanded that involves inappropriate interaction of an adult with a child
the incident needs to be reported immediately to CCLD El Segundo Regional Office of Child Care.
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emotional health or safety of any child.
This was not done as evidenced by:Based on interviews and documentation obtained the incident did occur of conduct inimical.
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Type A
10/22/2020
Section Cited
CCR
101223(a)(1)
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101223 (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by:
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LPA Rios discussed with the Director that the incident that led to a verbal and written warning and happened on more than one occassion was in violation of the child's personal rights and should have been reported immediately. Director agress to have a staff meeting that discusses reporting requirements.
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Based on interviews and documentation received the child was subject to conduct inimical by staff on more than one occasion.
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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: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2020
LIC9099 (FAS) - (06/04)
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