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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197416531
Report Date: 05/11/2021
Date Signed: 05/11/2021 08:31:47 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/25/2021 and conducted by Evaluator Alicia Mooberry
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20210325133304
FACILITY NAME:PAGE LEARNING ACADEMY, INC. IIIFACILITY NUMBER:
197416531
ADMINISTRATOR:THERESA HOLMESFACILITY TYPE:
850
ADDRESS:4724 S. WILTON PLACETELEPHONE:
(323) 299-7243
CITY:LOS ANGELESSTATE: CAZIP CODE:
90062
CAPACITY:46CENSUS: 10DATE:
05/11/2021
UNANNOUNCEDTIME BEGAN:
02:11 PM
MET WITH:Sheriee James, DirectorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Facility is in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alicia Mooberry conducted and unannounced complaint inspection to the above facility. Due to COVID-19 and precautionary measures this inspection was conducted via tele-conference. The purpose of the inspection was to deliver finding for the above allegation. This facility is located in same building as Infant Center #197416532.

LPA met with Shiree James, Director, who guided analyst on a tour of the facility. There were 10 children and 3 staff present during inspection.

Reporting party states that facility is in disrepair citing multiple areas of concern. LPA observed broken and missing ceiling tiles, air condititioner units and stove improperly installed, and missing emergency signs on doors leading outside. Per director, the owner of the building is in process of making repairs and acknowleged that above deficiencies.
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Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 54-CC-20210325133304
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PAGE LEARNING ACADEMY, INC. III
FACILITY NUMBER: 197416531
VISIT DATE: 05/11/2021
NARRATIVE
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Based on LPAs observations, interviews conducted, and photos obtained, the preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 Chapter 1 - 101238(a) Buildings & Grounds, are being cited on the attached deficiencies page

A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Sheriee James, Director. Appeal Rights were discussed and provided

*A copy of this report, Appeal Rights, Notice of Site Visit and the Acknowledgement of Receipt of Licensing Reports Form was sent to director via email with a return receipt request in lieu of signature.

Page 2 - End of Report

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20210325133304
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PAGE LEARNING ACADEMY, INC. III
FACILITY NUMBER: 197416531
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/11/2021
Section Cited
CCR
101238(a)
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101238 Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by
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Director will provide the department with proof of repairs to the facility by or before the POC due date.
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LPA observed broken and missing ceiling tiles, air condititioner units not functioning, stove in kitchen improperly installed, and missing emergency signs on doors leading outside.
This poses an immediate risk to the health and safety of the children in care.
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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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3