197403360-9-10-2020-12-CC-CBEL-BVNQVG-20201124113012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197403360
Report Date: 09/10/2020
Date Signed: 09/10/2020 11:16:52 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/03/2020 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20200903142621

FACILITY NAME:	YMCA METRO. L.A.-ANTELOPE VALLEY QUARTZ HILL SITE		FACILITY NUMBER:	197403360
ADMINISTRATOR:	CANDACE BEDNAR		FACILITY TYPE:	840
ADDRESS:	41820 50TH STREET WEST		TELEPHONE:	(661) 943-3303
CITY:	QUARTZ HILL	STATE: CA	ZIP CODE:	93536
CAPACITY:	105	CENSUS: 17	DATE:	09/10/2020
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Jessica Hernandez Director		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Allegation 3: Other: Staff not background cleared.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On September 10, 2020, Licensing Program Analyst (LPA), Brigitte Tsutaoka conducted an unannounced follow up inspection for the above complaint.

During this investigation, LPA Tsutaoka interviewed staff, children, and other relevant complaint parties. Based on the information obtained and interviews conducted the allegations are deemed Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur.

An exit interview was conducted, and a copy of this report was read and provided to Director Jessica Hernandez.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2020

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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