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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197417594
Report Date: 09/14/2021
Date Signed: 09/14/2021 04:46:19 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/24/2021 and conducted by Evaluator Isabel Ortega
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20210624140803
FACILITY NAME:KAI'S JUSTICE LEARNING ACADEMYFACILITY NUMBER:
197417594
ADMINISTRATOR:ADAMS, ALLEAFACILITY TYPE:
840
ADDRESS:2739 W. AVENUE LTELEPHONE:
(661) 718-3614
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:43CENSUS: 23DATE:
09/14/2021
UNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Yesica AparicioTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation: Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/14/2021, Licensing Program Analyst(LPA) Isabel Ortega conducted a subsequent inspection at the above facility regarding the allegation above. LPA disclosed the purpose of the investigation and was granted entry into the facility by the Director Yesica Aparicio. A tour of the facility was conducted, LPA verified a census of 23 children and a total of 4 Staff.
During today's investigation, LPA conducted child, parent and Staff interviews. Interviews with staff, children and other relevant individuals did not disclose any concerns of Staff yelling. Also, Facility has a storage area for hygiene supples to store mask, disinfecting spray, disinfecting wipe supplies, and seat covers. LPA observed restrooms with appropriate hygiene supplies. During the investigation It has been determined that the allegation of Personal Rights is deemed to be 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 allegation occurred.
An exit interview was conducted, a copy of this report and a notice of site visit report were provided to the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021
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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