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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198010922
Report Date: 06/24/2022
Date Signed: 06/24/2022 11:44:15 AM

Unsubstantiated


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
03/28/2022 and conducted by Evaluator Alicia Mooberry
COMPLAINT CONTROL NUMBER: 54-CC-20220328101924
FACILITY NAME:CUDAHY PRESCHOOL ACADEMYFACILITY NUMBER:
198010922
ADMINISTRATOR:ADOL VERGARAFACILITY TYPE:
850
ADDRESS:4912 CLARA STTELEPHONE:
(323) 771-8700
CITY:CUDAHYSTATE: CAZIP CODE:
90201
CAPACITY:60CENSUS: 0DATE:
06/24/2022
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Adol Vergara, Site SupervisorTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff did not discipline children in the same manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced complaint inspection on 06/24/22. LPA arrived at the facility at 11:10am to deliver the findings for the above allegation. LPA met with Adol Vergara, Site Supervisor. LPA observed, no children present during the inspection.

During the course of the investigation, LPA conducted interviews with complainant, school staff, child and parents. The complainant reported that Child #1 was not disciplined in the same manner resulting in Child #1 being terminated from the program. Interviews conducted with witnesses did not support the allegation.

LPA reviewed files of Child #1 and found records of communication with child’s authorized representative, documentation of child’s behavior, and referral for services. A review of files of Child #2 and Child #3 reveal similar communication log and behavior plan. LPA reviewed the Parent handbook signed by authorized representative which describes school policy of termination of services.
-----Report Continues on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
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 2
Control Number 54-CC-20220328101924
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: CUDAHY PRESCHOOL ACADEMY
FACILITY NUMBER: 198010922
VISIT DATE: 06/24/2022
NARRATIVE
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Written documentation was also obtained that indicates that the Site Supervisor terminated services for Child #1 in accordance with the termination of services policy.

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

Exit interview was conducted with Adol Vergara, Site Supervisor. Appeal Rights were discussed and a copy (LIC 9058) provided.

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.
SUPERVISOR'S NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2