197414572-1-24-2023-58-CC-KSTS-CNF2YD-20230125164834

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197414572
Report Date: 01/18/2023
Date Signed: 01/24/2023 05:49:21 PM

Unsubstantiated

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
11/03/2022 and conducted by Evaluator Lisa Clayton

PUBLIC

COMPLAINT CONTROL NUMBER: 58-CC-20221103140144

FACILITY NAME:	KIDSVILLE U.S.A.		FACILITY NUMBER:	197414572
ADMINISTRATOR:	PERERA, MAUREEN		FACILITY TYPE:	850
ADDRESS:	8472 CORBIN AVENUE		TELEPHONE:	(818) 886-3508
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	72	CENSUS: 39	DATE:	01/18/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	MAUREEN PERERA, DIRECTOR		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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PHYSICAL PLANT
RATIO
PERSONAL RIGHTS
PHYSICAL PLANT

INVESTIGATION FINDINGS:

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On 01/18/2023, LPA Clayton conducted an un-announced visit to deliver the findings on the above allegations. LPA was greeted by Director Maureen Perera. LPA Clayton toured the facility for Health & Safety inspection and observed 39 children in care, being supervised and cared for appropriately by 4 teachers and a floater.
LPA Clayton conducted the initial inspection on 11/08/2022 during which time, LPA Clayton interviewed 4 teachers and the Director, obtained the children's facility roster, class attendance sheets, personnel roster and documents related to the cleaning services provided to the CCC. A secondary inspection was conducted on 01/18/2023. During both visits, LPA Clayton conducted Health and Safety inspections of the 4 Pre-School classrooms, bathrooms and the kitchen and observed the facility to be clean, safe, sanitary and in good repair, ensuring the safety and well-being of the children in care. In all classes, LPA Clayton observed the student: teacher ratio to be in compliance with Title 22 Regulations.

LPA Clayton conducted a full investigation that included interviews, inspections, record and document review(s), and the information obtained did not reveal any evidence of the above-mentioned allegations. Therefore, the allegations are found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur.

Exit interview conducted and report was reviewed with Director Maureen Perera. A notice of site visit was given and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023

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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