197417697-6-16-2022-30-CC-LRIS-CFMS3S-20220622133134

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197417697
Report Date: 06/16/2022
Date Signed: 06/16/2022 11:58:55 AM

Substantiated

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
03/28/2022 and conducted by Evaluator Antonio Almanza

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20220328122805

FACILITY NAME:	AKCHEIRLIAN FAMILY CHILD CARE		FACILITY NUMBER:	197417697
ADMINISTRATOR:	AKCHEIRLIAN, ANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 288-2272
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	14	CENSUS:	DATE:	06/16/2022
		UNANNOUNCED	TIME BEGAN:	11:02 AM
MET WITH:	Licensee		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Reporting Requirements: Day care child received an injury while in care.

INVESTIGATION FINDINGS:

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On 06/13/2022 at 11:18 a.m., Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced site visit for the purpose of delivering finding for complaint received on 03/28/2022. Upon arrival there were were 2 adults and 6 children in care. Licensee AKCHEIRLIAN, ANI arrived at 11:32 am and LPA explained the purpose of the visit.During the course of the investigation, LPA Antonio Almanza conducted interviews and reviewed records regarding Allegation, Day care child received an injury while in care.

Childs parent reported, that after the infant child was picked up from the facility at 2:30 p.m., the child was whimpering and crying, of and on. The child’s parent swiped the child’s hair up from the forehead and observed a bruise and bump. The child’s parent contacted the Licensee via text at 4:28 p.m., provided a picture of the red marking on the child’s forehead and asked what happened.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

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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Control Number 30-CC-20220328122805

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AKCHEIRLIAN FAMILY CHILD CARE	FACILITY NUMBER: 197417697
	VISIT DATE: 06/16/2022

NARRATIVE

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At 5:03 p.m., the Licensee called the parent and notified the parent that she would check with her assistant because she did not know what happened. The Licensee was not at the facility at the time of the incident or when the child was picked up. During pick up, the Licensees assistant forgot to tell the parent about the incident. Staff 1 was present during the incident. Staff 1 is reporting that the child was running outside, when the child fell on the ground, hitting the child’s forehead, which caused the child’s forehead to get red. Staff placed ice on the child’s forehead and the redness did not go away.

As a result of the child continuing to cry at home, after being picked up, the child was taken to the emergency room (ER). The child was checked by a doctor, and the parent was advised to take the child back to the ER, if the child displayed symptoms of a head injury. LPA received photographs of the child's face where it is clearly visible that the child had a reddish oval marking on the forehead.

After considering all available information, the child sustained a bump and bruise on the forehead that resulted in the child being taken to the ER because of the child continued crying at home. The facility failed to notify the parents of the injury that the child sustained while in care. Based on interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

During today visit there is one Type A violation is being cited under California code of Regulations, Title 22, Division 12 & Chapter 1 (see LIC809D).

A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

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

A copy of this Report (809 & 809D), Appeal Rights, Acknowledgment of Receipt of Licensing Report (LIC 9224), and Notice of Site Visit (LIC 9213) were explained and provided to the Licensee ANI AKCHEIRLIAN.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC9099 (FAS) - (06/04)

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Control Number 30-CC-20220328122805

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AKCHEIRLIAN FAMILY CHILD CARE	FACILITY NUMBER: 197417697
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/16/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/17/2022 Section Cited CCR 102416.2(f)(1)	1 2 3 4 5 6 7	102416.2 (f)(1) Reporting Requirements, Any injury suffered by a child in care shall be reported to that child's parent or authorized representative regardless of treatment by a medical professional. This Requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will provide LPA a written statement of how the FCCH will communicate with parents and other staff any injuries children sustain while in care.
	8 9 10 11 12 13 14	Based on interview and record review, The Licensee and assistant did not notify the parent of the childs injury while in care, which poses an immediate Health and Safety, and personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC9099 (FAS) - (06/04)

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