191890481-9-8-2021-30-CC-SJSN-C6P2AD-20210908171320

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191890481
Report Date: 09/08/2021
Date Signed: 09/08/2021 03:23:39 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
06/10/2021 and conducted by Evaluator Dalicia Adkins

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20210610100044

FACILITY NAME:	PACOIMA EARLY EDUCATION CENTER		FACILITY NUMBER:	191890481
ADMINISTRATOR:	SUSAN HAN		FACILITY TYPE:	850
ADDRESS:	11059 HERRICK ST.		TELEPHONE:	(818) 896-3722
CITY:	PACOIMA	STATE: CA	ZIP CODE:	91331
CAPACITY:	115	CENSUS: 32	DATE:	09/08/2021
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Principal - Armando Inclan		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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9

Child in care touched inappropriately by staff

INVESTIGATION FINDINGS:

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On 9/8/21 at 11:40 am, Licensing Program Analyst (LPA) Dalicia Adkins conducted a virtual complaint tele-visit. LPA informed principal Armando Inclan the purpose of the tele-inspection and was guided on a virtual tour of the facility. In Room#1, there were 10 children (2-4 yrs old) and 4 teachers. Room#2 there were 13 children (2-4 yrs old) and 5 teachers. Room#3, there were 9 children (3yrs old-4 yrs old) and 3 teachers.
The purpose of today’s inspection is to conclude this investigation and deliver finding. Based on record reviews, observations and interviews it was determined that the above mentioned allegation is 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 evidence to prove that the alleged violation occurred. Exit interview conducted, a copy of this report sent to principal Armando Inclan via email.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

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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