197419412-6-2-2020-12-CC-JSAN-BQ7N64-20200602101030

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197419412
Report Date: 05/15/2020
Date Signed: 06/02/2020 10:10:29 AM

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
03/05/2020 and conducted by Evaluator Jacky San

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20200305143919

FACILITY NAME:	KAI'S JUSTICE CHILDCARE CENTER		FACILITY NUMBER:	197419412
ADMINISTRATOR:	JONES, AKEMIE		FACILITY TYPE:	840
ADDRESS:	2307 E. PALMDALE BLVD.		TELEPHONE:	(661) 947-5247
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93550
CAPACITY:	54	CENSUS: 3	DATE:	05/15/2020
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Adrienne Tolliver		TIME COMPLETED:	12:31 PM

ALLEGATION(S):

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Personal Rights - Facility is operating out of ratio
Neglect and Lack of Supervision - Child #1 and child #2 kick and punch child #3, child #4, child #5 and child #6
Qualifications - Teacher aide without required ECE courses supervised children alone
Other - Staff did not inspect children for illness
License - School age children were not physically separated from preschoolers during outdoor activity

INVESTIGATION FINDINGS:

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This report was amended on 06/02/2020 at xx PM, for the purpose of correcting the allegations.
On May 15, 2020 at 11:10 AM Licensing Program Analyst (LPA) San conducted a subsequent complaint investigation for the purpose of delivering findings and concluding the investigation regarding the above allegation through a telephone call due to the COVID-19 pandemic and met with Director, Adrienne Tolliver.

The investigation of the above allegations consisted of interviews with staff, and other relevant parties related to the allegations. The interviews conducted revealed the following evidence concerning facility operating out of ratio. There were no witnesses that disclosed that the facility was operating out of ratio. Interviews did not ensure that child#1 and child#2 kick and punch child#3, child#4, child#5 and child#6 and there was no proof to determine the cause. In addition, there was no evidence to determine a Teacher aide without required ECE courses supervised children alone. Interviews revealed staff inspect children for illnesses and at no time school-aged and pre-schooler children shared the play ground equipment; therefore the above allegations are deemed to be unsubstantiated.

An exit interview was conducted and a copy of this report was read and email to Director Adrienne Tolliver.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Jacky San	TELEPHONE: (661) 305-3690
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2020

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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