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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494264
Report Date: 11/09/2020
Date Signed: 11/09/2020 05:02:59 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
08/24/2020 and conducted by Evaluator Ericka Hill
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20200824154925
FACILITY NAME:MAPLE TREE ACADEMY WLA PRESCHOOLFACILITY NUMBER:
197494264
ADMINISTRATOR:CASPIAN, AMIRFACILITY TYPE:
850
ADDRESS:2920 S SEPULVEDA BLVDTELEPHONE:
(310) 314-1111
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY:80CENSUS: DATE:
11/09/2020
UNANNOUNCEDTIME BEGAN:
04:55 PM
MET WITH:Amir Caspian - LicenseeTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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9
Facility staff yell at daycare children.
INVESTIGATION FINDINGS:
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On November 9, 2020 at 4:55pm Ericka Hill, Licensing Program Analyst (LPA), spoke with Licensee, Amir Caspian to deliver the findings for the allegation above.

During an unannounced physical visit on October 6, 2020 and a tele-visit on October 8, 2020, LPA Hill did not observe any form of yelling or screaming used on or at the children. Corroborating evidence reveals teachers are caring for children age-appropriately.

Based on LPA observations, staff interviews, parent interviews, and record reviews the preponderance of evidence has not been met. Therefore, the allegation was found to be Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.
An exit interview was conducted and a copy of the LIC9099 as well as the Notice of Site Visit was emailed to Amir. LPA Hill requested Amir to sign and emailed the signed LIC9099 back to LPA Hill.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Ericka HillTELEPHONE: (424) 301-3029
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020
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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