198006258-7-15-2019-54-CC-KCHS-BE939P-20190719180326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198006258
Report Date: 06/21/2019
Date Signed: 07/15/2019 04:21:41 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
04/22/2019 and conducted by Evaluator Raul Navarro

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20190422140414

FACILITY NAME:	BELMONT SHORE CHILDREN'S CENTER		FACILITY NUMBER:	198006258
ADMINISTRATOR:	ANNA MARTINEZ		FACILITY TYPE:	850
ADDRESS:	30 S. TERMINO		TELEPHONE:	(562) 439-3369
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90803
CAPACITY:	70	CENSUS: 22	DATE:	06/21/2019
		UNANNOUNCED	TIME BEGAN:	08:26 AM
MET WITH:	Anna Martinez		TIME COMPLETED:	09:50 AM

ALLEGATION(S):

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Facility staff failed to follow the admissions agreement.

INVESTIGATION FINDINGS:

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THIS IS AN AMENDED REPORT TO REFLECT A CHANGE IN THE FINDINGS
Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection for the purpose of delivering the findings for the above allegation. LPA met with Director Anna Martinez who guided LPA on a tour of the facility. There was a total of 22 children present with four staff present during today's inspection.

During the course of the investigation conducted by LPA Navarro, interviews were conducted with the Site Director Anna Martinez. An attempt was made to interview the reporting party but to no avail. The complaint states that the admission agreement indicates that the facility will provide one week notice to parents when terminating services. Reporting party indicated that the Director did not provide a one week notice prior to terminating services for Child #1 and Chiild #2.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2019

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-20190422140414

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: BELMONT SHORE CHILDREN'S CENTER	FACILITY NUMBER: 198006258
	VISIT DATE: 06/21/2019

NARRATIVE

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LPA obtained a copy of the admission agreement that was signed by the reporting party. The signed agreement states,"Depending on the severity of the incident the facility reserves the right to terminate enrollment immediately."

During the Director's interview it was stated that Parent #1 made threatening remarks to Director over the phone. The Director stated that she did not feel safe and therefore terminated services.

Written documentation was also obtained that indicates that the Director terminated services for Child #1 and Child #2 because the Director no longer wants to provide child care services for Child #1 and Child #2, which is contrary to the Director’s statement.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore at this time the above allegation is unsubstantiated

Exit interview was conducted with Director Anna Martinez. 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 inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2019

LIC9099 (FAS) - (06/04)

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