197416039-5-5-2020-30-CC-MRUZ-BPCLRB-20200506085853

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197416039
Report Date: 05/05/2020
Date Signed: 05/05/2020 10:18:58 AM

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
02/24/2020 and conducted by Evaluator Margarit Sislyan

COMPLAINT CONTROL NUMBER: 30-CC-20200224152948

FACILITY NAME:	KIDS PARK NORTHRIDGE		FACILITY NUMBER:	197416039
ADMINISTRATOR:	ROSS/DAVIDA/&/TAUBY		FACILITY TYPE:	850
ADDRESS:	9056 TAMPA AVENUE		TELEPHONE:	(818) 998-5437
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	30	CENSUS: 5	DATE:	05/05/2020
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Tauby Ross		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Lack of supervision - Day care child was hit by another day care child resulting in bruising;
Personal Rights - Day care child sustained injury while in care
Ratio - Facility operating out of ratio
Physical Plant - Facility is unsanitary

INVESTIGATION FINDINGS:

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Tele-Visit via Face-time
LPA Sislyan conducted Tele-Visit via Face-time on 5/5/2020 at 9:27 AM and talked to Tauby Ross, Licensee. Tauby gave a tele-tour to LPA. LPA observed there were 5 preschool and 3 school age children at the facility during the visit. LPA observed two teachers and the Licensee were present at the facility during the visit. During the investigation LPA conducted site visit, interviewed people relevant to the investigation. LPA reviewed sign in/out sheets and other documents.
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.
Licensee 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: 05/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2020

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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