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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197492945
Report Date: 10/05/2021
Date Signed: 10/05/2021 05:13:23 PM



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
09/29/2021 and conducted by Evaluator Brigitte Tsutaoka
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20210929134051

FACILITY NAME:KIDS TOWN CHILDCARE CENTER, LLCFACILITY NUMBER:
197492945
ADMINISTRATOR:ANA GARCIAFACILITY TYPE:
840
ADDRESS:1825 WEST AVENUE J, SUITE 125TELEPHONE:
(661) 951-2070
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:45CENSUS: 18DATE:
10/05/2021
UNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Ana GarciaTIME COMPLETED:
05:25 PM
ALLEGATION(S):
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Allegation 3: Staff commingle day care children
Allegation 4: Staff does not post weekly menus
INVESTIGATION FINDINGS:
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On October 5, 2021 at 11:25AM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection on the above allegations. LPA disclosed the purpose of inspection and was granted entry by Director Ana Garcia who guided LPA on a tour of the facility. LPA counted 18 children in care with 2 staff.

At 11:30AM, LPA observed the facility menu posted in the kitchen with no date and not posted in an area available for parents to view. Director stated each parent receives a menu in their sign in folder. Director escorted LPA outside to view the sign in folders. LPA did not observe menus in the sign in folder nor posted in an area accessible to parents. LPA provided consultation to Director to post menus in window next to front door.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 12-CC-20210929134051
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KIDS TOWN CHILDCARE CENTER, LLC
FACILITY NUMBER: 197492945
VISIT DATE: 10/05/2021
NARRATIVE
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At 12:30PM, Director stepped out to conduct pick ups from school for school aged children as it was a minimum day. Director returned at 1:10PM with 1 school aged child.

At 1:10PM, LPA observed Staff 1 (who had left to complete school pick ups) return with 2 school aged children and addressed the Preschool teachers to "send over" Child 1. LPA walked over to school aged room and spoke with Staff 1 who stated Child 1 was in the preschool room. LPA addressed Child 1 who disclosed he is 7 years old. LPA observed Child 1 commingle with the preschool age children in the preschool room and then be redirected to school aged class when teacher returned.

Based on evidence obtained and observations conducted, the preponderance of evidence standard has been met, therefore the above allegations are found Substantiated. California Code of Regulations, Title 22, Division 12 Chapter 1 101227 Food Services Type B violation and 101538.3 Indoor Activity Space for School-Aged Children Type A violation are being cited during this inspection. See LIC9099D for deficiency details.

Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent. A copy of the Acknowledgment of receipt of licensing report (LIC9224) was
provided and must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

An exit interview was conducted, a copy of this Report, Appeal Rights, and Notice of Site Visit was provided to Director.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 12-CC-20210929134051
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KIDS TOWN CHILDCARE CENTER, LLC
FACILITY NUMBER: 197492945
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/12/2021
Section Cited
CCR
101227(a)(6)
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101227 Food Services (a)(6)Menus shall be... posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days.
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Director agreed to provide current menu with dates and provide a picture of menus posted in an area accessible to parents to the Department no later than 10/12/2021.
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This requirement was not met as evidence by: Based on observation and record review, facility staff failed to post menus in an area accessible to the parents, which poses a potential Health and Safety risk to children in care.
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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: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 12-CC-20210929134051
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KIDS TOWN CHILDCARE CENTER, LLC
FACILITY NUMBER: 197492945
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/06/2021
Section Cited
CCR
101538.3(b)
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101538.3 Indoor Activity Space for School Aged Children (b) In combination programs, indoor activity space provided for school-age child care center children shall be physically separated from... child care center children. This requirement was not met as evidence by:
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Director agreed to submit a plan to the Department addressing how to maintain different components in the combination separate no later than 10/06/2021.
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Based on observation, facility staff failed to keep school aged and preschool children separate by permitting Child 1 to be in the preschool classroom until Staff 1 returned from school pick ups.
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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: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5