197494264-6-21-2022-30-CC-CESO-CFU6XV-20220628211232

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197494264
Report Date: 06/21/2022
Date Signed: 06/21/2022 03:49:23 PM

Unsubstantiated

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
04/11/2022 and conducted by Evaluator Denise Miranda

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20220411120701

FACILITY NAME:	MAPLE TREE ACADEMY WLA PRESCHOOL		FACILITY NUMBER:	197494264
ADMINISTRATOR:	AMY SICILIANO		FACILITY TYPE:	850
ADDRESS:	2920 S SEPULVEDA BLVD		TELEPHONE:	(310) 314-1111
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY:	80	CENSUS: 58	DATE:	06/21/2022
		UNANNOUNCED	TIME BEGAN:	01:31 PM
MET WITH:	Amy Siciliano, Director		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Day care children sustained injuries while in care.
Staff handled day-care in a rough manner resulting in injury.
Staff withheld milk from day-care children.

INVESTIGATION FINDINGS:

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On 06/21/2022 at 1:31PM, Licensing Program Analyst (LPA) Denise Miranda conducted a visit at 2920 Sepulveda Blvd, Lo Angeles, CA 90064, for the purpose of delivering the investigation finding for the above-mentioned allegations. LPA Miranda met with Amy Siciliano, Director and informed the purpose of the visit. There are 59 children with 8 Staff and Director present at the facility.
Based on the information gathered throughout the course of the investigation which include LPA observations, interviews, documents obtained, and review of records the allegations 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 Amy Siciliano, Director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022

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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