197417594-9-14-2021-12-CC-CBEL-C75TSS-20210923145938

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197417594
Report Date: 09/14/2021
Date Signed: 09/14/2021 04:47:01 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 ACADEMY		FACILITY NUMBER:	197417594
ADMINISTRATOR:	ADAMS, ALLEA		FACILITY TYPE:	840
ADDRESS:	2739 W. AVENUE L		TELEPHONE:	(661) 718-3614
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	43	CENSUS: 23	DATE:	09/14/2021
		UNANNOUNCED	TIME BEGAN:	04:31 PM
MET WITH:	Yesika Aparicio and Adrienne Tolliver		TIME COMPLETED:	04:55 PM

ALLEGATION(S):

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Allegation: Record Keeping- Facility is operating out of Capacity
Allegation: Record Keeping- Facility is operating out of Ratio

INVESTIGATION FINDINGS:

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On 9/14/2021, Licensing Program Analyst(LPA) Isabel Ortega conducted a subsequent inspection to deliver findings for the above allegations. LPA disclosed the purpose of the investigation and was granted entry into the facility by the Director Yesica Aparicio and Adrienne Tolliver. 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. On both investigation occasions LPA observed facility was within capacity and within ratio. Interviews with staff and other relevant individuals did not disclose over capacity nor ratio concerns. During the facility tour It was determined that the allegations under license record keeping- capacity and Ratio are 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 Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (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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