197494263-8-26-2021-30-CC-PFLS-C6FJSH-20210901071822

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197494263
Report Date: 08/26/2021
Date Signed: 08/26/2021 01:29:45 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
06/22/2021 and conducted by Evaluator Denise Miranda

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20210622124025

FACILITY NAME:	MAPLE TREE ACADEMY WLA-INFANT		FACILITY NUMBER:	197494263
ADMINISTRATOR:	STEPHANIE CHACON MEDINA		FACILITY TYPE:	830
ADDRESS:	2920 S SEPULVEDA BL		TELEPHONE:	(310) 314-1111
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY:	70	CENSUS: 47	DATE:	08/26/2021
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Stephanie Chacon, Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff interact with children inappropriately

INVESTIGATION FINDINGS:

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On 08/26/2021 at 12:50PM, Licensing Program Analyst (LPA) Denise Miranda conducted a visit at 2920 Sepulveda Blvd, Lo Angeles, CA 90064, or the purpose of investigating the above-mentioned allegation. Upon arrival, LPA Miranda were greeted by Ms. Stephanie Chacon Medina, Director, and discussed the purpose of the visit.
LPA observed 47 Infants with 12 Infant Teachers and Director. All adults present are associated to the facility.

Based on the information gathered throughout the course of the investigation which include LPA observation and interviews, the allegation above is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there are not a preponderance of the evidences to prove that the alleged violation occurred.

An exit interview was conducted, and a copy of this report was provided to Stephanie Chacon Medina, Director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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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