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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197404630
Report Date: 05/02/2019
Date Signed: 05/03/2019 08:40:51 AM



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
02/25/2019 and conducted by Evaluator Margarit Sislyan
COMPLAINT CONTROL NUMBER: 30-CC-20190225100309
FACILITY NAME:VILLAGE TODDLER CENTERFACILITY NUMBER:
197404630
ADMINISTRATOR:KATHY RAMIREZFACILITY TYPE:
830
ADDRESS:3216 WEST VICTORY BLVD.TELEPHONE:
(818) 843-4468
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY:28CENSUS: 19DATE:
05/02/2019
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Bridget CantrellTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Lack of supervisin
INVESTIGATION FINDINGS:
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 Margarit Sislyan, Licensing Program Analyst (LPA) arrived at the facility to continue the investigation and deliver the investigation findings. LPA met with Bridget Cantrell, Director and toured the facility.
During the visit LPA conducted a site inspection and the facility was in a substantial compliance.
During the investigation LPA interviewed parties and reviewed all evidence relevant to the allegation.
Based on LPA’s observation, interviews conducted and preponderance of evidence the above allegation is substantiated, means that the allegation is valid because the preponderance of the evidence standard has been met.
Facility was cited Type A deficiency, according to California Code of Regulations Title 22 See 809D report for deficiencies. A copy of this report must be copied and given to all parents and to the parents of any child enrolling within the next 12 months.
Licensee is to post notice of Site Visit for 30 Days, failure to do so will result in $100 immediate civil penalty.
Exit Interview Conducted

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
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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Control Number 30-CC-20190225100309
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: VILLAGE TODDLER CENTER
FACILITY NUMBER: 197404630
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/02/2019
Section Cited
CCR
101229(a)
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Responsibility for Providing Care and Supervision.
The licensee shall provide care and supervision as necessary to meet the children's needs.

Child had unexplained injuries.
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Licensee will conduct staff training Regarding care and supervision. The agenda and the list of attendees submit to CCLD.

POC date is 05/12/19
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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.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
LIC9099 (FAS) - (06/04)
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