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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419527
Report Date: 10/27/2020
Date Signed: 10/27/2020 03:59:37 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
07/30/2020 and conducted by Evaluator Adrian Risher
COMPLAINT CONTROL NUMBER: 30-CC-20200730164348
FACILITY NAME:JUS KIDS ACADEMYFACILITY NUMBER:
197419527
ADMINISTRATOR:VITELA, MARIANAFACILITY TYPE:
830
ADDRESS:11211 WESTERN AVETELEPHONE:
(323) 777-0704
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:11CENSUS: 3DATE:
10/27/2020
UNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:candice addison, administratorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
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5
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7
8
9
Neglect/Lack of Supervision:Child received an unexplained injury
INVESTIGATION FINDINGS:
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2
3
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5
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7
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9
10
11
12
13
On 10/27/2020 at 2:50pm, Licensing Program Analyst (LPA) Adrian Risher, conducted a subsequent complaint televisit regarding the above-mentioned allegation. LPA spoke with Candice Addison, Administrator. LPA explained the purpose of the inspection. There were 3 infants in care with 1 infant teacher.


LPA Risher conducted interviews with Administrator and Staff during today's visit. During the previous visit on 08/17/2020, LPA received a copy of the personnel report and facility roster via email. Administrator and staff stated that the parent is notified when a child is injured at the daycare either verbally or in writing. Staff 1 stated that the staff use the first aid kit to disinfect any injuries. Administrator stated that the they use an icepack on the child for any injuries from the chest up. Staff stated that a child is separated from their group if they are unable to keep their hands to themselves. Parents are notified in writing when it is a consistent issue.

Unsubstantiated
Estimated Days of Completion: 89
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (434) 301-3061
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2020
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-20200730164348
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: JUS KIDS ACADEMY
FACILITY NUMBER: 197419527
VISIT DATE: 10/27/2020
NARRATIVE
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32
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the above alleged violations did or did not occur, therefore the allegations are found to be unsubstantiated.

Exit interview was conducted and a copy of the report was provided. A Notice of Site visit was provided.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (434) 301-3061
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2