197750053-2-1-2022-12-CC-CBEL-CBFNC9-20220208092021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197750053
Report Date: 02/01/2022
Date Signed: 02/01/2022 12:27:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/18/2021 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20211118135053

FACILITY NAME:	IT'S A SMALL WORLD CHILD CARE		FACILITY NUMBER:	197750053
ADMINISTRATOR:	YESENIA CANCHOLA		FACILITY TYPE:	850
ADDRESS:	44221 10TH ST. WEST		TELEPHONE:	(661) 802-4734
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	24	CENSUS: 17	DATE:	02/01/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Yesenia Canchola		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

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Allegation 2: Day care child pulled another day care child's hair.
Allegation 3: Staff not providing adequate food service for day care child.

INVESTIGATION FINDINGS:

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On February 1, 2022, Licensing Programa Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection on the above allegations. LPA disclosed the purpose of inspection and was granted entry Licensee, Yesenia Canchola. During inspection, 17 preschool children were present with 2 staff on association list.

During investigation, LPA conducted interviews with staff, parents, and obtained facility records. Based on evidence obtained and interviews conducted, the above allegations are deemed Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations did or did not occur.

An exit interview was conducted, a copy of this Report and Notice of Site Visit were provided to Licensee.

Unsubstantiated

Estimated Days of Completion: 75

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2022

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/18/2021 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20211118135053

FACILITY NAME:	IT'S A SMALL WORLD CHILD CARE		FACILITY NUMBER:	197750053
ADMINISTRATOR:	YESENIA CANCHOLA		FACILITY TYPE:	850
ADDRESS:	44221 10TH ST. WEST		TELEPHONE:	(661) 802-4734
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	24	CENSUS: 17	DATE:	02/01/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Yesenia Canchola		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

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Allegation 1: Daycare child fell resulting in an injury.

INVESTIGATION FINDINGS:

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On February 1, 2022, Licensing Programa Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection on the above allegation. LPA disclosed the purpose of inspection and was granted entry by Licensee, Yesenia Canchola. During inspection, 17 preschool children were present with 2 staff on association list.

During investigation, LPA conducted interviews with staff, parents, and obtained facility records. Through the course fo the investigation, it was determined Child 1 sustained a mild abrasion to the top of her right cheek during outdoor play. On 10/19/21, Staff observed the injury on Child 1's cheek, immediately applied basic first aid, attempted to make contact with the parent, and submitted an "Ouch Report" on the Hey Mama Application to the parent disclosing the injury. On the date of incident, two staff were present with 11 children during outdoor play (within ratio). Based on interviews, the incident causing the injury was not observed by staff and it is unknown how the injury occurred, but it did occur at the facility while Child 1 was playing outside during outdoor play.

Substantiated

Estimated Days of Completion: 75

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2022

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

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 12-CC-20211118135053

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: IT'S A SMALL WORLD CHILD CARE	FACILITY NUMBER: 197750053
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/01/2022

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	101229 Responsibility for Providing Care and Supervision (a)(1)(1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement was not met as evidence by:	1 2 3 4 5 6 7	Licensee agreed to have all staff watch the Supervising Children in Child Care training video on https://ccld.childcarevideos.org/child-care-center-operators/supervising-children-in-child-care-centers/ and submit a completed sign in sheet to the department
	8 9 10 11 12 13 14	Based on interview and record review, staff failed to observe how Child 1 sustained an abrasion on her right cheek beneath her eye which poses a potential Health and Safety Risk to children in care.	8 9 10 11 12 13 14	with staff names and signatures no later than 02/18/2021.
	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: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 12-CC-20211118135053

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: IT'S A SMALL WORLD CHILD CARE	FACILITY NUMBER: 197750053
	VISIT DATE: 02/01/2022

NARRATIVE

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Based on evidence collected and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found Substantiated. California Code of Regulations, Title 22, Division 12 Chapter 1, 101229 Responsibility for Providing Care and Supervision Type B violation is being cited on attached LIC9099D.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.

An exit Interview was conducted, a copy of this Report, Appeal Rights, and a Notice of Site visit was provided to the Licensee.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4