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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494316
Report Date: 12/02/2022
Date Signed: 12/02/2022 11:26:40 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
09/07/2022 and conducted by Evaluator Antonio Almanza
COMPLAINT CONTROL NUMBER: 58-CC-20220907090928
FACILITY NAME:FUTURE STARS ACADEMYFACILITY NUMBER:
197494316
ADMINISTRATOR:OLSHANSKY, IRENEFACILITY TYPE:
850
ADDRESS:4946-50 W 20TH& 5005 W 21ST STTELEPHONE:
(323) 937-7827
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:116CENSUS: 36DATE:
12/02/2022
UNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Director Sara PoageTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Allegation: Facility does not provide a safe environment for day care children.
Allegation: Staff are not adequately trained.
INVESTIGATION FINDINGS:
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On 12/02/2022 at 8:27 AM, Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced site visit for the purpose of delivering findings for complaint allegations received by the department on 11/16/22 associated to Complaint Control Number 58-CC-20220907090928. LPA met with Sara Poage, Director, and explained the purpose of the visit. During today’s visit there are 8 adults providing care to 36 children.

During the course of the investigation, LPA Almanza conducted observations and reviewed records regarding Allegation, facility does not provide a safe environment for day care children; and Allegation, staff are not adequately trained.

pg 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
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 9
Control Number 58-CC-20220907090928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494316
VISIT DATE: 12/02/2022
NARRATIVE
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Allegation, facility does not provide a safe environment for day care children:

According to the Allegations, C1 sustained injuries while in care because the playground used is not age appropriate. The Reporting Party (RP) disclosed that RP does not know what playground is used by C1 and has not seen the playground. LPA Almanza conducted an unannounced site visit on 09/15/22 and 11/16/22 and observed the equipment surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed areas around climbing equipment and slides with cushioning material to absorb falls.

Allegation, staff are not adequately trained:

The Reporting Party (RP) disclosed that the reason RP reported that staff are not adequately trained is because RP did not like Staff 8 (S8) mannerisms and the way S8 interacted with RP and C1. LPA Almanza reviewed S8 file and observed that S8 has the minimum requirements for a preschool teacher.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

A copy of this Report, Notice of Site Visit, and Appeal Rights were explained and provided to Sara Poage, Assistant Director and Irene Olshansky, Administrator/Owner.



Pg 2 of 2.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
09/07/2022 and conducted by Evaluator Antonio Almanza
COMPLAINT CONTROL NUMBER: 58-CC-20220907090928

FACILITY NAME:FUTURE STARS ACADEMYFACILITY NUMBER:
197494316
ADMINISTRATOR:OLSHANSKY, IRENEFACILITY TYPE:
850
ADDRESS:4946-50 W 20TH& 5005 W 21ST STTELEPHONE:
(323) 937-7827
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:105CENSUS: 36DATE:
12/02/2022
UNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Director Sara PoageTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
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8
9
Allegation: Day care child has been bitten while in care.
INVESTIGATION FINDINGS:
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On 12/02/2022 at 8:30 AM, Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced site visit for the purpose of delivering findings for complaint allegations received by the department on 11/16/22, associated to Complaint Control Number 58-CC-20220907090928. LPA met with Sara Poage, Director, and explained the purpose of the visit. During today’s visit there are 8 adults providing care to 36 children.

During the course of the investigation, LPA Almanza conducted interviews and reviewed records regarding allegation, day care child has been bitten while in care.

The Reporting Party (RP) reported that Child 1 (C1) was bitten on 10/20/2021 and 11/05/2021. The RP provided emails with photographs, from the facility, for the 2 incidents. RP disclosed that the facility did not give an explanation of what caused the incidents or what was done to prevent the incidents from happening.
pg 1 of 3
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 9
Control Number 58-CC-20220907090928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494316
VISIT DATE: 12/02/2022
NARRATIVE
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On 10/20/2021, Staff 6 (S6) and Staff 1 (S1) where present when C1 was bitten on the shoulder while eating breakfast. The photographs show that the bite did not break the skin and left a red oval marking on the right shoulder of C1. The email does not indicate if Staff observed the incident or what event lead to the incident. LPA interviewed S1 and S6 and staff did not recall the incident.

On 11/05/2021, Staff 6 (S6) “was present as the incident occurred to prevent any markings”; Space was the reason given for C1 being bitten. The photographs show that the bite did not break the skin and left a red oval marking on the back of the left hand near his thumb. The email does not indicate if Staff observed the incident or what event lead to the incident. LPA interviewed S6 and staff did not recall the incident.

After considering the available information, the facility did not provide C1 with a safe environment to keep C1 from being bitten while in care.

Based on LPAs observation and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC9099D.

One Type B Violation is being issued under California code of Regulations, Title 22, Division 12 & Chapter 1, section 1101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 daysduring the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

A copy of this Report, Notice of Site Visit, and Appeal Rights were explained and provided to Sara Poage, Director.
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SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 9
Control Number 58-CC-20220907090928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494316
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/23/2022
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This Requirement is not met as evidenced by:
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Facility will have a staff meeting/training with all staff on proper supervision and proper accident recording of incidents.
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Based on interview and record review, The Licensee did not provide C1 with a safe environment to keep C1 from being bitten while in care, which poses a potential Health or Safety, or personal rights risk to persons in care.
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Facility will provide LPA with proof by 12/23/22.
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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: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
09/07/2022 and conducted by Evaluator Antonio Almanza
COMPLAINT CONTROL NUMBER: 58-CC-20220907090928

FACILITY NAME:FUTURE STARS ACADEMYFACILITY NUMBER:
197494316
ADMINISTRATOR:OLSHANSKY, IRENEFACILITY TYPE:
850
ADDRESS:4946-50 W 20TH& 5005 W 21ST STTELEPHONE:
(323) 937-7827
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:116CENSUS: 36DATE:
12/02/2022
UNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Director Sara PoageTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation: Day care child sustained injuries while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/02/2022 at 8:27 AM, Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced site visit for the purpose of delivering findings for complaint allegations received by the department on 11/16/22 associated to Complaint Control Number 58-CC-20220907090928. LPA met with Sara Poage,Director, and explained the purpose of the visit. During today’s visit there are 8 adults providing care to 36 children.

During the course of the investigation, LPA Almanza conducted interviews and reviewed records regarding allegation, day care child sustained injuries while in care.

Pg 1 of 4
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 9
Control Number 58-CC-20220907090928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494316
VISIT DATE: 12/02/2022
NARRATIVE
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The Reporting Party (RP) reported that on 02/16/22, 05/19/22, 08/15/22 and 09/14/22 Child 1 (C1) sustained injuries while in care. The RP provided emails with photographs, from the facility, for the 4 incidents. RP disclosed that the facility did not explain what was done to prevent the incidents from happening.

On 02/16/2022, Staff 5 (S5) approached C1 in the yard and noticed 2 red marking's on C1s forehead; S5 does not know how the child received the red marks. The photograph shows a red circular mark over the left eyebrow and a red blemish from the right eyebrow up to the hairline. LPA interviewed S5 and staff did not recall the incident. It is unknown if Staff observed the incident or if the Staff attempted to prevent the incident from happening.

On 05/19/2022, C1 and another student wanted the same bike when C1 was scratched on his face. The photograph shows 3 small red vertical striations down the left cheek of C1. Staff 7 (S7) wrote the Incident Report. LPA was unable to interview S7 due to the staff no longer working at the facility. It is unknown if S7 observed the incident or if the S7 attempted to prevent the incident from happening. Facility is unable to provide any further information for this incident.

On 08/15/2022, C1 and another student were playing on a green net in the playground, when C1 tripped and bumped his mouth on the ground. As a result, C1 sustained a cut to his bottom lip, upper lip, and a chipped tooth. As a result of the incident C1 had to be taken to the Dentist. According to Staff 1, 2, and 3 the green netting/mesh fencing was put near the classroom, to keep children in their play area and from running to the classroom door. Staff 8 (S8) wrote the Incident Report. LPA was unable to interview S8 due to the staff no longer working at the facility. It is unknown if S8 observed the incident or if S8 attempted to prevent the incident from happening. Facility is unable to provide any further information for this incident.

On 09/14/2022, C1 tripped over C1s footing, falling forward and scratching C1s face. The photograph shows a red circular blemish with small red vertical lines below the corner of the right eye. Staff 1 (S1) stated that all the children and C1 were running outside when C1 tripped and fell. S1 did not observe C1 fall; S1 turned away before C1 fell on the floor. S1 stated that they are always telling the children not to run but does not remember telling C1 not to run when the incident occurred. Staff stated that C1 falls a lot.
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SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 9 of 9
Control Number 58-CC-20220907090928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494316
VISIT DATE: 12/02/2022
NARRATIVE
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After considering the available information, the facility did not provide C1 with the necessary care and supervision required to keep C1 from sustaining injuries while in care.
Based on LPAs observation and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC9099D.

One Type A Violation is being issued under California code of Regulations, Title 22, Division 12 & Chapter 1, section 101229 Responsibility for Providing Care and Supervision, (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time… Supervision shall include visual observation.

Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection).


**In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

A copy of this Report, Notice of Site Visit, and Appeal Rights were explained and provided to Sara Poage, Assistant Director.




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SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 8 of 9
Control Number 58-CC-20220907090928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FUTURE STARS ACADEMY
FACILITY NUMBER: 197494316
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/05/2022
Section Cited
CCR
101229(a)(1)
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7
101229 Responsibility for Providing Care and Supervision, (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher… Supervision shall include visual observation.
This Requirement is not met as evidenced by:
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Facility will provide all staff with memo on proper supervision and proper accident recording of incidents.
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Based on observation, interview and record review, The Licensee did not provide C1 with the necessary care and supervision required to keep C1 from sustaining injuries while in care, which poses an immediate or Health and Safety, and personal rights risk to persons in care.
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Facility will provide LPA copy of memo with signature by 12/05/22
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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: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 7 of 9