198015695-6-16-2022-33-CC-CGUA-CG3RXQ-20220706132505

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198015695
Report Date: 06/16/2022
Date Signed: 06/16/2022 04:39:08 PM

Substantiated

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
04/07/2022 and conducted by Evaluator Cynthia Reyes

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20220407123011

FACILITY NAME:	CHERRY BLOSSOM CHILDCARE & PRESCHOOL		FACILITY NUMBER:	198015695
ADMINISTRATOR:	LYNN MARROQUIN		FACILITY TYPE:	840
ADDRESS:	906 S. GRAND AVENUE		TELEPHONE:	(626) 335-5500
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY:	45	CENSUS:	DATE:	06/16/2022
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Lynn Marroquin		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Personal Rights

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Cynthia Reyes conducted an unannounced site inspection to present the findings of the above complaint allegations. LPA met with Director Lynn Marroquin, who guided the LPA on a tour of the facility. Due to COVID- 19 precautionary measures were taken by the LPA who wore appropriate personal protective equipment during the entire inspection.

Based upon LPA interviews, the allegation that “Children are calling each other names” has been determined to be Substantiated. It was stated that the school age children came up with nick names for each other and are calling each other these names, however some children dont like the name given and some children keep calling them the name and teasing and it hurts their feelings and makes them cry.

Per interviews some staff have heard the children call each other these nick names and have told children they are ok with the names, however they are not aware that some of these nick names hurt a child's feelings. Nick names used are Ninja Turtle, Concrete, Apple, Grape and Group chat. ffff

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

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 33-CC-20220407123011

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: CHERRY BLOSSOM CHILDCARE & PRESCHOOL	FACILITY NUMBER: 198015695
	VISIT DATE: 06/16/2022

NARRATIVE

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Per interviews some staff have heard the children call each other these nick names and have told children they are ok with the names, however they are not aware that some of these nick names hurt a child's feelings. Nick names used are Ninja Turtle, Concrete, Apple, Grape and Group chat.

A finding of Substantiated means that the preponderance of evidence standard has been met. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06, Section 101223 "Personal Rights" is being cited on the attached LIC 9099D. Please refer to 9099D for documentation of deficiencies.

Please refer to 9099D for documentation of deficiencies.

This agency has investigated the complaint alleging an admission agreement allegation. We have found that the complaint was unfounded, meaning the allegation was false, could not have happened and/or is without a reasonable basis. A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Exit interview was conducted with Director Lynn Marroquin.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20220407123011

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: CHERRY BLOSSOM CHILDCARE & PRESCHOOL	FACILITY NUMBER: 198015695
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/16/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/16/2022 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	PERSONAL RIGHTS The licensee shall ensure that each child is accorded the following personal rights: To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director states she had a training exercise regaridng social bullying with the school age children and school age staff.
	8 9 10 11 12 13 14	Based on interviews conducted school age children are calling each other nick names that some children don't like their nick name and it hurts their feelings and makes them cry. Licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons 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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC9099 (FAS) - (06/04)

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