198016139-10-14-2021-54-CC-TCON-C93NJ9-20211124092952

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198016139
Report Date: 10/14/2021
Date Signed: 10/14/2021 10:53:52 AM

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
08/26/2021 and conducted by Evaluator Katrina Chicote

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20210826105029

FACILITY NAME:	MISSION KIDZ CHILD CARE CENTER		FACILITY NUMBER:	198016139
ADMINISTRATOR:	ANDREA CANALES		FACILITY TYPE:	850
ADDRESS:	415 W. TORRANCE BLVD.		TELEPHONE:	(310) 386-0690
CITY:	CARSON	STATE: CA	ZIP CODE:	90745
CAPACITY:	50	CENSUS: 17	DATE:	10/14/2021
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Naomi Iosia, Director		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff did not provide the truth about incidents that occurred to Authorized representatives

INVESTIGATION FINDINGS:

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On 10/14/2021 at 11:00 AM, LPA met with Naomi Iosia, Director, for the purpose of delivering findings. LPA observed seventeen children and three adults at time of inspection. LPA made observations, conducted interviews and record reviews during course of investigation.

This agency has investigated the above complaint and found that although the allegation may have happened or is valid; based on observations and interviews there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the allegation is deemed UNSUBSTANTIATED.

Exit interview conducted with Director, Naomi Isoia, on 10/14/2021 at 11:45 AM. A copy of the Appeal Rights were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.

Report Ends - Page 1 of 1

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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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