197417453-1-20-2022-30-CC-MRUZ-CAV8KX-20220120213553

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197417453
Report Date: 01/20/2022
Date Signed: 01/20/2022 02:02:15 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
10/22/2021 and conducted by Evaluator Silva Garibyan

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211022111045

FACILITY NAME:	CORONA ACADEMY CAMPUS/CA. CHILDRENS ACADEMY		FACILITY NUMBER:	197417453
ADMINISTRATOR:	CHAVEZ,JENNY		FACILITY TYPE:	850
ADDRESS:	13036 SHERMAN WAY		TELEPHONE:	(818) 764-4054
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91605
CAPACITY:	48	CENSUS: 18	DATE:	01/20/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Jenny Chavez/Director		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Personal Rights: Child sustained an unexplained injury while in care
Persoanl Rights: Child not accorded dignity with personal relationship to staff

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Silva Garibyan conducted a visit to the facility for the purpose of delivering the findings on the above allegation.

LPA Garibyan met with Jenny Chavez , Site Supervisor, and toured the facility with her on January 20, 2022 at 1:30 PM. There were 18 children, one teacher, and two TAs present at the time of the visit. Based upon the evidence obtained through the course of investigation which include observations at the facility, interview with relevant parties there is insufficient evidence to support or disprove that Child sustained an unexplained injury while in care and Child not accorded dignity with personal relationship to staff. Therefore, these allegations have been determined unsubstantiated. A finding that the complaint is 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.
An exit interview was conducted and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

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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