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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191806578
Report Date: 11/10/2021
Date Signed: 11/10/2021 10:12:43 AM



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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/23/2021 and conducted by Evaluator Lissete Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20210923085500
FACILITY NAME:CHILDREN'S INSTITUTE INTERNATIONAL DAY CARE CENTERFACILITY NUMBER:
191806578
ADMINISTRATOR:HERTISTINE TAYLORFACILITY TYPE:
850
ADDRESS:711 S. NEW HAMPSHIRE AVE.TELEPHONE:
(213) 385-5100
CITY:LOS ANGELESSTATE: CAZIP CODE:
90005
CAPACITY:24CENSUS: 10DATE:
11/10/2021
UNANNOUNCEDTIME BEGAN:
09:02 AM
MET WITH:Karen Martinez, Lead TeacherTIME COMPLETED:
10:27 AM
ALLEGATION(S):
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Day care child was sexually abused by staff while in care.
Day care child was not accorded privacy while in care.
INVESTIGATION FINDINGS:
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On 11/10/2021 at 9:02AM, Licensing Program Analyst (LPA) Lissete Gonzalez, conducted an unannounced Complaint Inspection to conclude the investigation regarding the above complaint allegations. LPA met with Lead Teacher, Karen Martinez. There were ten (10) children present.

During the course of the investigation, interviews were conducted with staff, children, and other witnesses by LPA L. Gonzalez and Investigations Branch (IB) Investigator, Tiffany Brunelli. LPA obtained copies of the facility roster, personnel roster, staff and children’s records, and other documentation. This agency has investigated the complaint allegations of (1) Day care child was sexually abused by staff while in care and (2) Day care child was not accorded privacy while in care.

Based on the evidence, this agency has determined the allegations are unsubstantiated. Although the
allegation(s) may have happened or is valid there is not a preponderance of evidence to prove the alleged
REPORT CONTINUES ON NEXT PAGE: 1 OF 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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 33-CC-20210923085500
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S INSTITUTE INTERNATIONAL DAY CARE CENTER
FACILITY NUMBER: 191806578
VISIT DATE: 11/10/2021
NARRATIVE
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violation did or did not occur, therefore the allegation(s) is unsubstantiated. Per California Code of Regulations Title 22, Division 12, no deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Lead Teacher, Karen Martinez.

END OF REPORT PAGE: 2 OF 2
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2