198016424-12-9-2020-33-CC-ACHO-BW6LG7-20201210074416

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198016424
Report Date: 12/09/2020
Date Signed: 12/09/2020 04:53:59 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
06/26/2020 and conducted by Evaluator Justin Dorsey

COMPLAINT CONTROL NUMBER: 33-CC-20200626083349

FACILITY NAME:	KIDDIE ACADEMY OF GLENDORA		FACILITY NUMBER:	198016424
ADMINISTRATOR:	BETH HOLMES		FACILITY TYPE:	840
ADDRESS:	1339 SOUTH GRAND AVENUE		TELEPHONE:	(626) 691-0242
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY:	27	CENSUS: 14	DATE:	12/09/2020
		UNANNOUNCED	TIME BEGAN:	12:41 PM
MET WITH:	Heather Jenkins		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff failed to report the incident to the children’s authorized representatives.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Justin Dorsey contacted the facility via telephone to deliver complaint investigation findings due to COVID-19 and pre-cautionary measures. LPA Dorsey identified himself and discussed the purpose of the call. LPA Dorsey delivered the investigation findings to acting director Heather Jenkins.

As part of the investigation, LPA obtained a work order from a visit to the center by Southern California Gas Company dated 06/24/20 and the facilities staff and children's roster.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2020

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-20200626083349

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: KIDDIE ACADEMY OF GLENDORA	FACILITY NUMBER: 198016424
	VISIT DATE: 12/09/2020

NARRATIVE

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LPA Dorsey conducted interviews with with staff members, facilities acting director, complainant, children, and parents of the program. According to interviews with the acting director, it was found that the facility did not report the smell of gas coming from a dryer in the staff's break room on 06/24/20. The smell of gas resulted in a visit from Southern California Gas Company on 06/24/20. During an interview with the acting director, it was found that on 06/24/20 there was a smell of gas coming from the dryer for about a half-hour or less. Per Jenkins when Southern California Gas Company came to the facility, they found that the dryer was venting from the inside causing the smell of gas. This can also be seen on the work order provided to LPA Dorsey by the facility from Southern California Gas Company which states "dryer venting inside".

Based on documents and LPA interviews the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division 12, Chapter 1) will be cited on the attached LIC 9099D.

An exit phone interview was conducted with acting director Heather Jenkins and a copy of this report was signed by LPA Dorsey. This report along with the LIC 9213 will be sent via email to acting director Heather Jenkins 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.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2020

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20200626083349

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: KIDDIE ACADEMY OF GLENDORA	FACILITY NUMBER: 198016424
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/09/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/08/2021 Section Cited CCR 101212(d)(1)(c)	1 2 3 4 5 6 7	101212 Reporting Requirements (d)(1)(c)...during the operation of the child care...report shall be made to the Department by telephone or fax within the Department's next working day...a written report containing the information...shall be...within seven days. Events reported shall include...Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. requirement is not met as evidenced by:	1 2 3 4 5 6 7	Per acting director she will conduct a training with staff on reporting requirements and send proof to LPA Doresy by POC due date of 01/08/20.
	8 9 10 11 12 13 14	Based on interview there was a smell of gas in the facility that was not reported, which poses a potential Health, 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: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2020

LIC9099 (FAS) - (06/04)

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