197415051-10-18-2022-30-CC-CESO-CKF29M-20221021171211

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197415051
Report Date: 10/18/2022
Date Signed: 10/18/2022 06:48:07 PM

Substantiated

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
07/25/2022 and conducted by Evaluator Keyona Scott

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20220725102930

FACILITY NAME:	BUCKNER EDUCATIONAL CHRISTIAN ACADEMY		FACILITY NUMBER:	197415051
ADMINISTRATOR:	LESLIE BUCKNER		FACILITY TYPE:	830
ADDRESS:	2330 W. FLORENCE AVENUE		TELEPHONE:	(323) 789-6154
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90043
CAPACITY:	16	CENSUS: 9	DATE:	10/18/2022
		UNANNOUNCED	TIME BEGAN:	03:44 PM
MET WITH:	Lead Teacher- Ms. Tonia		TIME COMPLETED:	07:01 PM

ALLEGATION(S):

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REPORTING REQUIREMENTS: staff did not report outbreak at facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Keyona Scott, conducted an unannounced inspection to the Child Care Center on 10/18/2022, for the purpose of delivering findings regarding complaint control number: 30-CC-20220725102930. This is a dual licensed facility, in which, preschool program (facility # 197415049) is also on premises. LPA spoke with Director, Leslie Buckner, via telephone and was instructed Lead Teacher, (S1), Ms. Tonia, would assist with today's inspection. LPA met with Lead Teacher (S1) at 3:40 PM, when conducting inspection for prschool program. LPA observed proper infant to teacher ratios, nine (9) infants to four (4) staff in the infant center at 3:44 PM. All Adults present, working and/or volunterring have a criminal record clearance or exemption.

During today's inspection, LPA conducted follow-up interviews.

It was alleged that staff did not report outbreak at facility. Based in interviews conducted, parents were notified of the outbreak at the facility. PAGE 1

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

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-20220725102930

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BUCKNER EDUCATIONAL CHRISTIAN ACADEMY	FACILITY NUMBER: 197415051
	VISIT DATE: 10/18/2022

NARRATIVE

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Based on record review, Director did not inform Child Care Licensing of the infectious outbreak of hand, foot and mouth at the facility, which poses a potential risk to the health, safety and/or personal rights to the children in care. Based on record review, information obtained and interviews conducted, the preponderance of evidence standard has been met, therefore, the allegation of, REPORTING REQUIREMENTS, staff did not report outbreak at facility, is SUBSTANTIATED. California Code of Regulation, Title 22, 101212(d)(1)(E) is being cited on the attached LIC9099D.

The following was thoroughly discussed:

Lead Teacher was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Lead Teacher, Ms. Tonia.

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SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC9099 (FAS) - (06/04)

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Control Number 30-CC-20220725102930

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BUCKNER EDUCATIONAL CHRISTIAN ACADEMY	FACILITY NUMBER: 197415051
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/18/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/01/2022 Section Cited CCR 101212(d)(1)(E)	1 2 3 4 5 6 7	Reporting Requirements Upon the occurrence... of any of the events specified in (d)(1) below, a report shall be made to the Department... (1) Events reported shall include the following:... (E) Epidemic outbreaks. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director, Lead Teacher and Office Director will review Reporting Requirements CCR 101212 and conduct training amongst each other as leads of the facility and write declarations on how each plans to adhere and comply with reporting requirements. Each referenced staff person above will provide completed and signed declaration to LPA no later than
	8 9 10 11 12 13 14	Director failed to report infectious outbreak of hand, foot and mouth to Child Care Licensing within the regulated sepcfied timeframe, which poses a potential health, safety, and/or personal rights risks to the children in care.	8 9 10 11 12 13 14	11/01/2022.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC9099 (FAS) - (06/04)

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