197750055-11-27-2023-12-CC-LKIG-CYRVZR-20231222155306

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197750055
Report Date: 11/27/2023
Date Signed: 11/27/2023 12:55:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 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
10/18/2023 and conducted by Evaluator Mayra Rivera

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20231018125742

FACILITY NAME:	ONE TAEKWONDO, THE		FACILITY NUMBER:	197750055
ADMINISTRATOR:	KIM, HYOSEOP		FACILITY TYPE:	840
ADDRESS:	26246 BOUQUET CANYON ROAD		TELEPHONE:	(661) 673-3396
CITY:	SANTA CLARITA	STATE: CA	ZIP CODE:	91350
CAPACITY:	30	CENSUS: 0	DATE:	11/27/2023
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Kyra Oakely, Director		TIME COMPLETED:	01:12 PM

ALLEGATION(S):

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Staff do not ensure facility is clean and orderly.
Staff denied parent access to the facility without sufficient cause.
Staff do not require signatures from individuals signing day care children in/out.
Staff transported a day care child in an inappropriate child restraint seat.

INVESTIGATION FINDINGS:

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On Monday, November 27, 2023, at 10:20 a.m., Licensing Program Analyst (LPA), Mayra Rivera conducted an unannounced complaint inspection and to deliver findings regarding staff do not ensure facility is clean and orderly, staff denied parent access to the facility without sufficient cause, staff do not require signatures from individuals signing day care children in/out and staff transported a day care child in an inappropriate child restraint seat. During this visit, LPA Rivera interviewed director.

During the course of this investigation, Licensing Program Analyst Mayra Rivera conducted interviews with parents, staff, children and reviewed documentation. Of the four interviews conducted with parents, all disclosed no concerns with the care provided at the facility, their children have not mentioned any concerns, they like the services provided by One Taekwondo, they stated the facility is clean and orderly, their children utilize One Taekwondo transportation, they all sign out their children during pick up. One stated their child does not need a booster or car seat, one parent stated child uses either a booster or car seat

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra Rivera	TELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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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Control Number 12-CC-20231018125742

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: ONE TAEKWONDO, THE	FACILITY NUMBER: 197750055
	VISIT DATE: 11/27/2023

NARRATIVE

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one parent stated their child uses a car seat and the other parent stated their child uses a booster chair.
Of the three interviews conducted with children, all disclosed like coming to One Taekwondo, they place their personal items inside a bin, the masters clean the floor mats, mom, dad or parents pick them up from One Taekwondo. One child stated they sit in a car seat, the other child stated they sit in a booster and the other child stated does not sit in a booster or car seat.

Of the three interviews conducted with staff all explained the cleaning procedure, explained where children store their personal belongings, explained the transportation policy and the use of a car seat or booster chair, and the sign in and out procedure. LPA Rivera observed the cleaning solutions that are utilized for cleaning and disinfecting the floor mats. Facility utilizes Mr. Clean antibacterial Summer Citrus and 70% Isopropyl Alcohol. LPA reviewed the parent handbook and observed information regarding transportation, sign in/sign out procedure and termination by One Taekwondo. LPA observed the facility to be cleaned and observed the bins where children store their personal belongings. LPA also reviewed the sign in/sign out sheets from October 9, 2023 to November 1st, 2023 and LPA did not observe full legal signature from parents or staff only observe times.

This agency has investigated the complaint. At this time, it is determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore at this time the above allegation is unsubstantiated. A technical violation has been given for regulation 101229.1 Sign In and Sign Out (a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following:
(1). The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

Exit interview was conducted with Director Kyra Oakley. The director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

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

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra Rivera	TELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC9099 (FAS) - (06/04)

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