197414041-4-10-2020-30-CC-PFLS-BNKVK3-20200411162941

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197414041
Report Date: 04/10/2020
Date Signed: 04/10/2020 01:31:09 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
01/15/2020 and conducted by Evaluator Karren Starks

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20200115085428

FACILITY NAME:	CCRC HEAD START-ARTHUR D. AVILA		FACILITY NUMBER:	197414041
ADMINISTRATOR:	ARMINE BAGUMYAN		FACILITY TYPE:	850
ADDRESS:	7304 JORDAN AVENUE		TELEPHONE:	(818) 715-9640
CITY:	CANOGA PARK	STATE: CA	ZIP CODE:	91303
CAPACITY:	52	CENSUS: 0	DATE:	04/10/2020
		UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Shawntel Williams.		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

PERSONAL RIGHTS - Child's conduct presents a risk to other day care childrens safety.

INVESTIGATION FINDINGS:

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

On 04/10/2020, Licensing Program Analyst (LPA) Karren Starks advised Early Learning Supervisor, Shawntel Williams of the conclusion of complaint investigation. The visit was conducted by way of tele-visit with the staff being advised of an e-mail with the LIC 9099 attached and a Return Receipt for acknowledgement which would consitute the receipt of the report

Based on observation, interviews conducted and information the facility has protocols in place to offer assistance to Child 1 which is having a one on one with the child each day. In the event C1 has an episode the other children in care are removed from the immediate area of C1 while a staff member and the one on one de-escalate the situation, ensuring that the other children in care remain safe. Other services are being offered to C1's family and they are receptive to the offers. With the above information the allegation of Personal Rights is being deemed unsubstantiated due to the protocols in place for the facility. Staff advised LPA that C1 is not longer in program due to relocating out of state.
No deificiency cited. Copy of report is being e-mailed.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Karren Starks	TELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2020

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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