197494323-2-11-2022-30-CC-MNEL-CBMVQT-20220214153848

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197494323
Report Date: 02/11/2022
Date Signed: 02/11/2022 01:22:27 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
11/17/2021 and conducted by Evaluator Sabrina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211117080136

FACILITY NAME:	CRYSTAL STAIRS HEAD START - INGLEWOOD SOUTHSIDE		FACILITY NUMBER:	197494323
ADMINISTRATOR:	CARDENAS, LAURA		FACILITY TYPE:	850
ADDRESS:	3937 WEST 104TH STREET		TELEPHONE:	(323) 421-2662
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90303
CAPACITY:	32	CENSUS: 20	DATE:	02/11/2022
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Ruth Molina, Education Coordinator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Day care child sustained injuries in care.

INVESTIGATION FINDINGS:

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On 02/11/2022 at 12:45 PM, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced site visit and met with Ruth Molina, Education Coordinator, for the purpose of delivering the investigation findings for the above-mentioned allegation.

On 11/18/2021 at 12:00 PM, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced complaint visit and met with Ruth Molina, Education Coordinator. During the visit, LPA interviewed facility staff and obtained the Child Care Facility Roster, Children’s Records, and Incident Report.

LPA conducted interviews with facility staff members, day care children, parents and reviewed the following documents: Facility Staff Written Statements, Incident Report, Child Care Facility Roster, and Children’s Records. Based upon the evidence obtained throughout the course of the investigation, it was revealed that staff did not visually observe the child being scratched at the time of the injury, although the staff asked the child, the child had 2 different versions of what occurred.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

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 4

Control Number 30-CC-20211117080136

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CRYSTAL STAIRS HEAD START - INGLEWOOD SOUTHSIDE	FACILITY NUMBER: 197494323
	VISIT DATE: 02/11/2022

NARRATIVE

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Therefore, this allegation has been substantiated. Substantiated – A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Per facility staff, the child was wearing a face mask all day. After lunch, the child used the restroom, and got in bed for nap time. By that time, child was fine, did not complain or state anything. When child stood up from the bed, staff noticed a scratch on child’s face, and was bleeding a little bit. The injury was immediately wiped and cleaned.

Although Child was observed to be fine, however, this could pose a potential threat to the child’s health and safety. Type B deficiency is cited today, 02/11/2022. (See LIC 809-D for deficiency cited)

An exit interview was conducted and a copy of this report, Appeal Rights, and Notice of Site Visit were provided to Ruth Molina, Education Coordinator.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 30-CC-20211117080136

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CRYSTAL STAIRS HEAD START - INGLEWOOD SOUTHSIDE	FACILITY NUMBER: 197494323
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/11/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/18/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by: On 11/10/2021, staff failed to visually observe child and as a result	1 2 3 4 5 6 7	Licensee shall immediately ensure all children are visually observed at all time. Licensee shall submit a written declaration of steps taken to ensure children are supervised at all time to the department no later than 02/18/2022.
	8 9 10 11 12 13 14	child sustained a scratch on face. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

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
11/17/2021 and conducted by Evaluator Sabrina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211117080136

FACILITY NAME:	CRYSTAL STAIRS HEAD START - INGLEWOOD SOUTHSIDE		FACILITY NUMBER:	197494323
ADMINISTRATOR:	CARDENAS, LAURA		FACILITY TYPE:	850
ADDRESS:	3937 WEST 104TH STREET		TELEPHONE:	(323) 421-2662
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90303
CAPACITY:	32	CENSUS: 20	DATE:	02/11/2022
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Ruth Molina, Education Coordinator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff spoke inappropriately to day care child(ren).

INVESTIGATION FINDINGS:

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On 02/11/2022 at 12: 45 PM, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced site visit and met with Ruth Molina, Education Coordinator, for the purpose of delivering the investigation findings for the above-mentioned allegation. On 11/18/2021 at 12:00 PM, Licensing Program Analyst (LPA) Sabrina Martinez conducted an unannounced complaint visit and met with Ruth Molina, Education Coordinator. During the visit, LPA interviewed facility staff and obtained the Child Care Facility Roster, Children’s Records, and Incident Report. LPA conducted interviews with facility staff members, day care children, parents and reviewed the following documents: Facility Staff Written Statements, Incident Report, Child Care Facility Roster, and Children’s Records.

Based upon the evidence obtained throughout the course of the investigation, the allegation that Staff spoke inappropriately to day care child(ren) is unsubstantiated. Unsubstantiated: The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview and a copy of this report, Notice of Site Visit, along with Appeal Rights were explained and provided to Ruth Molina, Education Coordinator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sabrina Martinez	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 4