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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 192006239
Report Date: 12/09/2021
Date Signed: 12/09/2021 10:56:21 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 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
10/11/2021 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20211011120205
FACILITY NAME:MAOF CHILD CARE CENTER PRESCHOOLFACILITY NUMBER:
192006239
ADMINISTRATOR:RAMIRO RIVERAFACILITY TYPE:
850
ADDRESS:6110 HOLMES AVE.TELEPHONE:
(323) 585-6181
CITY:LOS ANGELESSTATE: CAZIP CODE:
90001
CAPACITY:120CENSUS: 11DATE:
12/09/2021
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Ramiro RiveraTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection on 12/9/21. LPA Navarro arrived at the facility at 09:10pm and met with Director Ramiro Rivera. LPA conducted the inspection to conduct interviews and deliver the findings to the above allegation. There were 35 children with 12 staff present during today's inspection.

During the course of the investigation, LPAs toured the facility and conducted interviews with staff, children in care, and parents. Reporting Party was not interviewed due to being anonymous. Interviews conducted did not disclose any information consistent with the allegation, therefore the allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted Director Ramiro Rivera, during which appeal rights (LIC 9058) were explained and their signature on this form acknowledges receipt of these forms.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
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 54-CC-20211011120205
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: MAOF CHILD CARE CENTER PRESCHOOL
FACILITY NUMBER: 192006239
VISIT DATE: 12/09/2021
NARRATIVE
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The Notice of Site Visit (LIC 9213) was posted where the parent/guardian of children enter and exit the facility and must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2