197418547-3-8-2022-30-CC-MNEL-CCE6QE-20220310200035

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197418547
Report Date: 03/08/2022
Date Signed: 03/08/2022 02:01:08 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
12/15/2021 and conducted by Evaluator Sabrina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211215152647

FACILITY NAME:	IKAR EARLY CHILDHOOD CENTER		FACILITY NUMBER:	197418547
ADMINISTRATOR:	JANE ROSEN		FACILITY TYPE:	850
ADDRESS:	1564 BURNSIDE AVENUE		TELEPHONE:	(323) 634-1870
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	54	CENSUS: 22	DATE:	03/08/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Licensee Dr. Jane Rosen		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Day care child sustained injury while in care

INVESTIGATION FINDINGS:

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On 03/08/2022 at 1:00 PM, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced site visit and met with Licensee Dr. Jane Rosen for the purpose of delivering the investigation findings for the above-mentioned allegation.

On 12/17/2021, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced complaint visit at the facility. During the visit, LPA inspected the playground area and observed the location of the “Jump-a-roo” jumping equipment. LPA observed this equipment near the playhouse area. LPA observed that underneath the “Jump-a-roo” is a fake grass/turf material. LPA did not observe any children using the equipment at the time of the visit. Licensee was informed that the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. During this visit, LPA also interviewed facility staff and obtained the Child Care Facility Roster, Staff Declarations, and Incident Report dated 11/10/2021.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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-20211215152647

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: IKAR EARLY CHILDHOOD CENTER	FACILITY NUMBER: 197418547
	VISIT DATE: 03/08/2022

NARRATIVE

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LPA conducted interviews with facility staff members, parents and reviewed the following documents: Facility Staff Declarations, Incident Report, Child Care Facility Roster, and Facility’s Policies and Procedures. Interviews with facility staff and review of records revealed that on 11/10/2021, there were 4 staff members and 13 children present in the playground. Staff #2 stated they were supervising the playground equipment and observed the incident. Staff #2 stated they were close enough but didn’t make it quite in time to catch the child before child fell. Staff #1 and Staff #3 stated they promptly assessed for any injury, cared for the child, and applied ice on the back of the child’s head. Facility staff monitored the child and parents were notified of the incident at 3:10 PM via text and phone call. Child was signed out and picked up at the facility at 4:30 PM. Facility staff and the child’s parent stated that the incident did not require any medical attention. The child returned to the facility the next day.

Based on the preponderance of information obtained from interviews, records, and observations, the incident was not a result of a California Code of Regulations, Title 22, Division 12 violation related to the lack of care and supervision section. Therefore, the allegation that child sustained an injury while in care is found to be unsubstantiated meaning although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of this report, Notice of Site Visit, and appeal rights were provided to Licensee Dr. Jane Rosen.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC9099 (FAS) - (06/04)

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