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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197405177
Report Date: 01/29/2020
Date Signed: 01/29/2020 06:02:44 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
01/27/2020 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20200127170706
FACILITY NAME:SAINT AUGUSTINE SCHOOL PRE-KFACILITY NUMBER:
197405177
ADMINISTRATOR:MINERVA RUBIOFACILITY TYPE:
850
ADDRESS:3819 CLARINGTON AVE.TELEPHONE:
(310) 838-3144
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:43CENSUS: 30DATE:
01/29/2020
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Minerva Rubio, DirectorTIME COMPLETED:
06:30 PM
ALLEGATION(S):
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Staff interfered with child's sleep.
Staff spoke in an inappropriate manner towards day-care child.
Staff made inappropriate comments in day-care child's presence.
INVESTIGATION FINDINGS:
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On 01/29/2020 at 9:30 AM, Licensing Program Analysts (LPA) Miriam Cohen conducted an unannounced visit for the purpose of notifying the director concerning the following alleged complaints: Staff interfered with child's sleep; Staff spoke in an inappropriate manner towards day-care child; Staff made inappropriate comments in day-care child's presence. Upon arrival, LPA observed five staff members providing care for 30 children. LPA met with Minerva Rubio, preschool director. LPA Cohen substantiated the above allegations based on the Unusual incident reported to the department on 01/28/2020, interviews conducted with one parent volunteer (witness), two teachers, and one director. The facility was cited a Type “A” deficiency (see attached 9099D) according to the CA Code of Regulations, Title 22, Division 12, Chapter 3. A copy of this report and LIC 9224 must be given to all parents and to the parents of any child enrolling within the next 12 months. Appeal Rights were provided. LIC 9213- Notice of Site Visit provided and must be posted for 30 days. Failure to do so for 30 consecutive days will result in immediate civil penalty assessment of $100. An exit interview and copy of report was conducted, explained, and provided to Ms. Rubio. LPA obtained copies of the following: Children Facility Roster with emergency ID, Teacher Roster, Sign in/Sign Out sheets, and written declaration from one parent volunteer, two teachers, and preschool director. SUBSTANTIATED- A finding that a complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
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 3
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
01/27/2020 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20200127170706

FACILITY NAME:SAINT AUGUSTINE SCHOOL PRE-KFACILITY NUMBER:
197405177
ADMINISTRATOR:MINERVA RUBIOFACILITY TYPE:
850
ADDRESS:3819 CLARINGTON AVE.TELEPHONE:
(310) 838-3144
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:43CENSUS: 30DATE:
01/29/2020
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:MinTIME COMPLETED:
06:30 PM
ALLEGATION(S):
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Staff hit day-care child.
INVESTIGATION FINDINGS:
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On 01/29/202 at 9:30 AM, Licensing Program Analysts (LPA) Miriam Cohen conducted an unannounced visit for the purpose of notifying the director concerning alleged complaint: Staff hits day care child.

Upon arrival, LPA observed five teachers providing care for 30 children. LPA Cohen met with Minerva Rubio, preschool director and Dr. Nguyen, school principal. Based on record reviews and interviews conducted with one parent volunteer, four teachers, preschool director, and principal (written declaration obtained), the following conclusion has been reached: UNSUBSTANTIATED.

Unsubstantiated – A finding that a 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20200127170706
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: SAINT AUGUSTINE SCHOOL PRE-K
FACILITY NUMBER: 197405177
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/29/2020
Section Cited
CCR
101223(a)(3)
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Personal Rights
The licensee shall ensure that each child is accorded the following personal rights:
(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference
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*Director agrees to visit ccld.ca.gov website and view videos pertaining to Personal rights.
*Director agrees to take a course on Personal Rights and teach/provide the same training during staff development
*Director agrees to require staff to self-certify and write a short paragraph regarding the content of the training
The above POC shall be submitted to LPA by 02/12/2020.
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with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. Based on interviews, staff interfered with child’s sleep, spoke inappropiately, and made inappropriate comments in child’s presence.
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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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3