198008932-8-6-2021-33-CC-CGUA-C5ZTFA-20210818144112

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198008932
Report Date: 08/06/2021
Date Signed: 08/06/2021 12:40:02 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/21/2021 and conducted by Evaluator Fabiola Vasquez

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20210521133400

FACILITY NAME:	KIDZONE PRE-SCHOOL & CHILDREN CENTER		FACILITY NUMBER:	198008932
ADMINISTRATOR:	BOOKER, LENORE		FACILITY TYPE:	850
ADDRESS:	1247 W. SAN BERNARDINO RD.		TELEPHONE:	(626) 967-1223
CITY:	COVINA	STATE: CA	ZIP CODE:	91722
CAPACITY:	39	CENSUS: 4	DATE:	08/06/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Narissa Groves		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility has lice outbreak.

INVESTIGATION FINDINGS:

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On 08/06/21 LPA Fabiola Vasquez conducted an unannounced complaint inspection. LPA meet with Angelica Gonzales, Teacher who guided LPA on tour of the facility there were 4 children present with 1 staff. LPA explained the purpose of the visit is to provide the Findings for the above allegation. Director, Narissa Groves, arrived shortly, who continued with the inspection.

Throughout the course of the investigation, interviews were conducted with Director, Staff (S) S1, S2, and Child (C) C1. Documentation in the form of a children roster, parent handbook, parent agreement, and permission slip for lice prevention spray were obtained.

Pertaining to the allegation that “Facility has lice outbreak” This allegation refers to an epidemic outbreak of head lice in the facility with several children in care.

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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 33-CC-20210521133400

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIDZONE PRE-SCHOOL & CHILDREN CENTER	FACILITY NUMBER: 198008932
	VISIT DATE: 08/06/2021

NARRATIVE

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Based on interviews conducted with Director, Staff (S) S1, S2, Child (C) C1. There were collaborating statements made by Director, S1 and S2 that C3, C4, C5, C6, C7 had head lice on May 13, 2021. In which the director was aware of three, C3, C4, C5, the director was not aware of two, C6, C7. Another statement by C1, who stated that the teacher showed him the lice. Documentation in the form of a children roster, parent handbook, parent agreement, and permission slip for lice prevention spray were also reviewed.

This agency has investigated the complaint alleging that " Facility has lice outbreak” The facility had an epidemic outbreak according to the definition as laid forth in Title 22.

This agency has investigated the complaint alleging that "Facility has a lice outbreak." Based upon the evidence as listed above, the preponderance of evidence standard has been met and the allegation
has been determined to be Substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06, Section 101226.1 "Daily inspection for illness" is being cited on the attached LIC 9099D.

Please refer to 9099D for documentation of deficiencies.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee/Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee/Director.

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

Exit interview was conducted with Director, Narissa Groves. LPA signed the report. Appeal Rights along with a copy of the report were explained and provided.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20210521133400

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIDZONE PRE-SCHOOL & CHILDREN CENTER	FACILITY NUMBER: 198008932
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/06/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/09/2021 Section Cited CCR 101226.1(a)(1)(B)(b)	1 2 3 4 5 6 7	101226.1 Daily Inspection for Illness (a) The licensee shall be responsible for ensuring that children with obvious symptoms but not limited to, fever or vomiting, are not accepted. (B)Have been exposed to a contagious disease.(b)The licensee shall develop and implement a written inspection procedure This requirement was not met as evidenced by	1 2 3 4 5 6 7	POC: Per administrator conducted deep cleaning, all the rugs were removed and treated for Lice. Faciity does not have stuff animals. Children are checked upon arrival. Nottified the parents virbally then by Attention Flyer informing parents to check thier children at home and facility will be checking them as well.
	8 9 10 11 12 13 14	There were collaborating statements made by Director, S1 and S2 that C3, C4, C5, C6, C7 had head lice on May 13, 2021. In which the director was aware of three, C3, C4, C5, the director was not aware of two, C6, C7. Another statement by C1, who stated that the teacher showed him the lice. This poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14	Permission slips to spray childrens hair with "Preventetive lice spray" to the parents of the children that were in attendance during the outbreak.
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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.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC9099 (FAS) - (06/04)

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