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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494574
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:17:20 PM

Substantiated


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
08/24/2022 and conducted by Evaluator Lisa Clayton
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20220824101350
FACILITY NAME:DEVONSHIRE PRESCHOOLFACILITY NUMBER:
197494574
ADMINISTRATOR:JACQUELINE SORIA LOPEZFACILITY TYPE:
850
ADDRESS:21203 DEVONSHIRE STREETTELEPHONE:
(818) 700-2821
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:60CENSUS: 25DATE:
10/20/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:JACQUELINE SORIA LOPEZ, DIRECTORTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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PHYSICAL PLANT
PERSONAL RIGHTS
PERSONAL RIGHTS
INVESTIGATION FINDINGS:
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On 10/20/2022, LPA Clayton conducted an un-announced visit to deliver the findings of the above allegations. LPA was greeted by teacher Cynthia Morales and later upon arrival, Director Jacqueline Soria Lopez. LPA Clayton toured the facility for a Health and Safety inspection, and observed 25 children in care, being handled and supervised appropriately by 4 teachers.

Based on LPAs interviews conducted with children, parents and staff, and LPAs observations, the preponderance of evidence standard has been met, therefore the above allegations ae found to be SUBSTANTIATED. (Title 22, 101238(a)(1) and 101223(a)(3) are being cited on the attached LIC 9099D.

An exit interview was conducted, Appeal Rights were given and discussed, and a Notice of Site Visit was given and must remain posted for 30 days.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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 3
Control Number 58-CC-20220824101350
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: DEVONSHIRE PRESCHOOL
FACILITY NUMBER: 197494574
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/20/2022
Section Cited
CCR
101238(a)(1)
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101238(a)(1)The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
(1) The licensee shall take measures to keep the center free of flies, other insects, and rodents.
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The Director provided LPA Clayton with invoices for continuing exterminator/pest control services to mitigate the insect problem. LPA instruced Director to submit future invoices to the ESRO.
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This requirement is not met as evidenced by: Based on LPA interviews with staff and children, who disclosed that there was an ongoing pest/cockroach issue, which poses immediate Health and Safety risks to children in care.
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Type B
10/20/2022
Section Cited
CCR
101223(a)(3)
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101223(a)(3)(a) The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.

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Director instructed to conduct training with all staff regarding personal rights and reporting requirements.
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This requirement is not met as evidenced by: Based on LPA interviews with staff who told a child in care, in front of other children, that if he did not behave, the bugs would come back. Which poses a Personal Rights risks to children in care.
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Director will provide a copy of the training agenda along with the Staff attendee signature via email no later than 10/27/2022.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 58-CC-20220824101350
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: DEVONSHIRE PRESCHOOL
FACILITY NUMBER: 197494574
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/20/2022
Section Cited
CCR
101223(a)(3)
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(a) The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.

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Director instructed to conduct training with all staff regarding personal rights and reporting requirements.
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This requirement is not met as evidenced by: Based on LPA interviews with staff who told a child in care, in front of other children, that if he did not behave, the bugs would come back. Which poses a Personal Rights risks to children in care.
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Director will provide a copy of the training agenda along with the Staff attendee signature via email no later than 10/27/2022.
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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.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3