197414574-1-5-2021-30-CC-MRUZ-BX2R7H-20210107114621

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197414574
Report Date: 01/05/2021
Date Signed: 01/05/2021 01:49:03 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
10/12/2020 and conducted by Evaluator Margarit Sislyan

COMPLAINT CONTROL NUMBER: 30-CC-20201012083300

FACILITY NAME:	KIDSVILLE U.S.A.		FACILITY NUMBER:	197414574
ADMINISTRATOR:	PERERA, MAUREEN		FACILITY TYPE:	840
ADDRESS:	8472 CORBIN AVENUE		TELEPHONE:	(818) 886-3508
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	57	CENSUS: 0	DATE:	01/05/2021
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Maureen Perera		TIME COMPLETED:	01:36 PM

ALLEGATION(S):

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Lack of Supervision - Lack of supervision resulting in day care children engaging in inappropriate behavior
Personal Rights - Staff yelled at day care children.
Personal Rights - Staff handled day-care child in a rough manner.

INVESTIGATION FINDINGS:

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Margarit Sislyan, Licensing Program Analyst (LPA) conducted tele-visit via Face-Time to continue the investigation of the above allegation and deliver the investigation findings.
LPA met with Maureen Perera, Owner via face time on 01/05/2021. Maureen Perera gave a tele-tour to the classrooms. LPA observed there were no children in the classroom.
During the investigation LPA interviewed people relevant to the above allegations. LPA reviewed supporting materials provided by the Licensee.
Based on LPA’s observation, interviews conducted and preponderance of evidence the above allegations are unsubstantiated, means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Maureen Perera has been advised that an email shall be sent with the report attached, which has been reviewed during the Tele-Visit and a read receipt via email shall be considered an acknowledgement that they are in receipt of this form.
Exit interview

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Margarit Sislyan	TELEPHONE: (424) 430-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2021

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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