198015866-12-23-2020-33-CC-CGAN-BWS3FH-20201229171245

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198015866
Report Date: 12/23/2020
Date Signed: 12/23/2020 01:43:54 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 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
08/18/2020 and conducted by Evaluator Anomeh Eivazian

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200818143812

FACILITY NAME:	LAD N LASSIE PRESCHOOL & INFANT		FACILITY NUMBER:	198015866
ADMINISTRATOR:	ANN DAVIS		FACILITY TYPE:	830
ADDRESS:	12620 BROADWAY STREET		TELEPHONE:	(562) 945-6466
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90601
CAPACITY:	40	CENSUS: 21	DATE:	12/23/2020
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Frank Arvizu, administrator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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The ages of children in care are being commingled.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anomeh Eivazian contacted a complaint inspection to the facility via telephone (facetime) for the purpose of delivering the complaint finding due to COVID-19 and pre-cautionary measures. LPA Eivazian identified herself and discussed the purpose of the call.

During this tele-inspection LPA met with Frank Arvizu, administrator who took this LPA on a tour of the facility. During this tour there were 21 infants present in the facility.

During this investigation, LPA Eivazian conducted interviews with staff and one parent. Copies of facility rosters and a copy of child#1 Identification and Emergency Information LIC 700 were obtained.

REPORT CONTINUES ON NEXT PAGE 1 OF 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

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 33-CC-20200818143812

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: LAD N LASSIE PRESCHOOL & INFANT	FACILITY NUMBER: 198015866
	VISIT DATE: 12/23/2020

NARRATIVE

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Based on interviews conducted with staff#1, staff#2, and staff#8, Potty Training classroom has children from 2 to 3 years of the age and falls under Preschool classrooms. Per staff#1, staff#2, and staff#8 once children turn 2 years old then they will be transferred to potty training classroom.

Based on interviews conducted with staff#4, staff#5 and parent #1, child#1 was transferred to potty training (preschool) classroom when was 22 or 23 months old (an infant).

Based on LPA Eivazian observations and information obtained, child#1 was transferred to potty training (preschool) classroom when was an infant (22-23 months old).

Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated at this time. California Code of Regulations, Title 22 101438.3 (b) is being cited on the attached LIC 9099D.

Upon receipt of this report, the Licensee shall post the Notice of Site visit and any licensing report documenting a type “A” deficiency. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. 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. Facility was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this tele inspection.

An exit phone interview was conducted with Frank Arvizu, administrator and a copy of this report was signed by LPA Eivazian. This report along with the LIC 9213, Notice of Site Visit will be sent via email to Frank Arvizu, administrator who agrees to sign and date the report. This report was sent via email and an electronic read receipt confirms receiving the report. The facility representative was provided with the mailing address for the Monterey Park Regional office and agrees to send the original report by mail.

REPORT ENDS PAGE 2 OF 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20200818143812

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: LAD N LASSIE PRESCHOOL & INFANT	FACILITY NUMBER: 198015866
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/23/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/23/2020 Section Cited CCR 101438.3(b)	1 2 3 4 5 6 7	Indoor Activity Space for Infants Indoor activity space for infants shall be physically separate from space used by children in the child care center and school-age child care center components. This requirement was not met as evidenced by …	1 2 3 4 5 6 7	Per Frank Arvizu, administrator from now on once infants turn 2 years of the age will be transferred to potty training (preschool) classroom.
	8 9 10 11 12 13 14	Based on interviews conducted with staff#4, staff#5 and parent #1, child#1 was transferred to potty training (preschool) classroom when was 22 or 23 months old (an infant) which poses an immediate Health and Safety, or Personal Rights risk to 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: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

LIC9099 (FAS) - (06/04)

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