198003136-4-20-2020-54-CC-TCON-BP66DE-20200429204302

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198003136
Report Date: 04/15/2020
Date Signed: 04/20/2020 03:39:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/31/2020 and conducted by Evaluator Timothy Fields

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20200131132841

FACILITY NAME:	Y.M.C.A GLB LOS ALTOS		FACILITY NUMBER:	198003136
ADMINISTRATOR:	BRIAN FLORES		FACILITY TYPE:	840
ADDRESS:	1720 BELLFLOWER		TELEPHONE:	(562) 596-3394
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY:	70	CENSUS: 8	DATE:	04/15/2020
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Janine Maldonado		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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9

Staff did not pick child up from school.

INVESTIGATION FINDINGS:

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A Complaint investigation was conducted by Licensing Program Analyst (LPA) Timothy Fields for the purpose of investigating the above allegation. LPA was informed a children was left behind at their elementary school by the facility driver on 11/18/19. Approximately four children are picked up from this particular elementary school. According to information obtained during interviews, the facility was informed the child would not need a ride in the morning but would need to be picked up after school. Due to documentation or driver error the child was left behind.

Based on interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California code of regulations,
101229 (a) Responsibility for Providing Care and Supervision, is being cited on the attached LIC 9099D.

An exit interview was conducted with Program Director Janine Maldonado via phone conversation. Appeal rights and a copy of this report will be emailed and/or mailed to the facility.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2020

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 54-CC-20200131132841

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: Y.M.C.A GLB LOS ALTOS	FACILITY NUMBER: 198003136
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/15/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/15/2020 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision: The licensee shall provide care and supervision as necessary to meet the children's needs.	1 2 3 4 5 6 7	Per Program Director and Executive director drivers are given a list of names with children that are to be picked up from school. Drivers are also given parent contact information to confirm a child is not to being picked up that day. LPA was provided a sample log sheet outlining the pick up and drop off schedule.
	8 9 10 11 12 13 14	The requirement is not met as evidenced by information obtained from interviews confirming a child was left behind at his elementary school by the facility driver during after school pick up. This poses an immediate risk to the health and safety of 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: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/31/2020 and conducted by Evaluator Timothy Fields

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20200131132841

FACILITY NAME:	Y.M.C.A GLB LOS ALTOS		FACILITY NUMBER:	198003136
ADMINISTRATOR:	BRIAN FLORES		FACILITY TYPE:	840
ADDRESS:	1720 BELLFLOWER		TELEPHONE:	(562) 596-3394
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY:	70	CENSUS: 8	DATE:	04/15/2020
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Janine Maldonado		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not treat daycare child equally.

INVESTIGATION FINDINGS:

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2
3
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5
6
7
8
9
10
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12
13

A Complaint investigation was conducted by Licensing Program Analyst Timothy Fields for the purpose of investigating the above allegation. After conducting interviews with staff, a child in care, and the child's parent, there was no conclusive evidence to suggest the child was not treated equally. Based on information obtained, there was an administrative dispute and other incidents involving the child's behavior, and as a result it was assumed the child was being mistreated.

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 the allegations are unsubstantiated. An exit interview was conducted with Program Director Janine Maldonado via phone conversation. Appeal rights and a copy of this report will be emailed and/or mailed to the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2020

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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