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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197403097
Report Date: 10/13/2023
Date Signed: 10/13/2023 11:03:28 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
06/28/2023 and conducted by Evaluator Maria Rendon
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230628140904
FACILITY NAME:SYDNEY M. IRMAS CHILD CARE CENTERFACILITY NUMBER:
197403097
ADMINISTRATOR:BROCKNER, MONICAFACILITY TYPE:
850
ADDRESS:7446 ALABAMA STREETTELEPHONE:
(818) 348-2867
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY:24CENSUS: 13DATE:
10/13/2023
UNANNOUNCEDTIME BEGAN:
09:13 AM
MET WITH:Jacqueline SylvestreTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Day care child sustained a fracture due to staff neglect
INVESTIGATION FINDINGS:
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On 10/13/2023 at 9:13 AM, Licensing Program Analysts (LPA) Maria Rendon made an unannounced inspection for the purpose of concluding the investigation on the above allegation and to deliver the findings for complaint received on 6/28/23 associated to the complaint number 58-CC20230628140904. LPA Rendon, met with Site supervisor Jacqueline Sylvestre and explained the purpose of the visit. During today’s visit Site Supervisor Jacqueline Sylvestre guided LPA on a tour of the facility. LPA observed 13 children under the care and supervision of Site Supervisor and 05 other staff member.

During the investigation conducted by the department, a copy of the roster was obtained, interviews were conducted, and other pertinent information was collected.

Information provided by the reporting party indicates that daycare child sustained a fracture due to staff neglect.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023
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 4
Control Number 58-CC-20230628140904
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SYDNEY M. IRMAS CHILD CARE CENTER
FACILITY NUMBER: 197403097
VISIT DATE: 10/13/2023
NARRATIVE
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The Department’s investigation revealed that Staff #1 provided conflicting and inconsistent information regarding how Child #1 sustained an injury at the facility. Investigation findings further revealed that Child #1 sustained a fracture at the facility. Staff #1 disclosed inconsistent information to both the parent of Child #1 and to licensing.

Based on interviews which were conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 12 Chapter 1 Section 101229(a)(1) Responsibility for Providing Care and Supervision, Section 101163(a) False Claims, and Section 101214(a) Accountability, are being cited on the attached deficiencies pages.

Due to Child #1 sustaining a serious injury and there was an absence of supervision, a civil penalty of $500 is being assessed during today’s visit.

An exit interview was conducted with Site Supervisor Jacqueline Sylvestre. A copy of this report, a Notice of Site Visit and Appeal Rights were provided to Site Supervisor Jacqueline Sylvestre.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 58-CC-20230628140904
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SYDNEY M. IRMAS CHILD CARE CENTER
FACILITY NUMBER: 197403097
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/16/2023
Section Cited
CCR
101229(a)(1)
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101229(a)(1) Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time… This requirement was not met as evidence by:
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All staff will participate in campus meetings on how to provide care and supervision so that children are supervised at all times. Site supervisor provided LPA Rendon a copy of a campus meeting minutes and agenda which took place on 8/16/2023.
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Based on observations, interviews, and record review, Child #1 was not supervised which resulted in child sustaining a fracture, which poses an immediate Health, Safety, and Personal Rights risk to children in care. A civil penalty of $500 is being assessed.
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Type B
10/20/2023
Section Cited
CCR
101214(a)
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101214(a) Accountability (a) The licensee, whether an individual or other entity, is accountable for the general supervision of the licensed child care center and for the establishment of policies concerning its operation…This requirement was not met as evidence by:
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All staff will continue to have campus meetings regarding accountability for the general supervision of children in care. Site Supervisor will email LPA Rendon maria.rendon@dss.ca.gov staff signatures participation and agenda on or before 10/20/23 end of business day.
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Based on observations, interviews, and record review, Child #1 sustained an injury in which Staff #1 did not display accountability for the supervision of children in care, which poses potential Health, Safety, and Personal Rights risk to children in care.
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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.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 58-CC-20230628140904
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SYDNEY M. IRMAS CHILD CARE CENTER
FACILITY NUMBER: 197403097
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/20/2023
Section Cited
CCR
101163(a)
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Type B: 101163(a) False Claims (a) No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the child care center... This requirement was not met as evidence by:
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Have staff meetings regarding good and honest communication regarding anything that happens in the center. Site Supervisor willl email LPA Rendon maria.rendon@dss.ca.gov staff signatures participation and agenda on or before 10/20/23 end of business day.
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Based on record review and interviews by S1, S1 revealed conflicting and inconsistent information, which poses potential Health, Safety, and Personal Rights risk to children in care.
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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.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023
LIC9099 (FAS) - (06/04)
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