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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419009
Report Date: 06/23/2022
Date Signed: 06/23/2022 12:36:47 PM

Unsubstantiated


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 Lillian J Casillas
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220328095722
FACILITY NAME:CII/HARVARD HEAD STARTFACILITY NUMBER:
197419009
ADMINISTRATOR:ANA PANIAGUAFACILITY TYPE:
850
ADDRESS:1506 W. 61ST STREETTELEPHONE:
(213) 385-5100
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:35CENSUS: 0DATE:
06/23/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Monique Anderson TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights: Staff put her hand over the daycare child's mouth.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/23/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced complaint visit for the purpose of delivering the findings of the investigation regarding the allegation above. Upon arrival, LPA observed the location is closed. LPA spoke with ECS Manager, Monique Anderson, over the phone who confirmed location is closed and stated Site Supervisor, Debbie Rivas, in a training.

On 4/19/2022, LPA Casillas initiated the complaint investigation and met with Site Supervisor. LPA interviewed Site Supervisor, Staff 2, Child 1, Child 2, and Child 3. LPA also obtained a copy of the children’s roster (LIC9040), Personnel Report (LIC500), and a copy of the 4110 Family Service History report for Child 1.

Not enough evidence was revealed through interviews with relevant parties. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not

[CONTINUE ON PAGE 2]
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 30-CC-20220328095722
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: CII/HARVARD HEAD START
FACILITY NUMBER: 197419009
VISIT DATE: 06/23/2022
NARRATIVE
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PAGE 2

occur. Therefore, the allegation is UNSUBSTANTIATED. There are no deficiencies cited during today’s visit.

An exit interview was conducted. A copy of this report was provided to ECS Manager, Monique Anderson, via email along with Appeal Rights and Notice of Site Visit. Monique Anderson replied to the email, stating the report was received and read in lieu of a signature.
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2