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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198016461
Report Date: 10/20/2020
Date Signed: 10/26/2020 08:22:48 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 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
09/08/2020 and conducted by Evaluator Tiffanie Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20200908140736
FACILITY NAME:KIDS FORUM PRESCHOOLFACILITY NUMBER:
198016461
ADMINISTRATOR:JANET TORRESFACILITY TYPE:
850
ADDRESS:4523 TWEEDY BLVD.TELEPHONE:
(323) 563-6568
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY:50CENSUS: DATE:
10/20/2020
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Janet Torres, DirectorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Sexual Abuse- A center staff inserted a toy car in child's anus.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Due to COVID-19 and precautionary measures, Licensing Program Analyst (LPA) T. Tran delivered this final finding of the above complaint allegation by use of via telephone with Licensee, Janet Torres on 10/20/2020.
During the course of the investigation through records reviewed and interviews conducted, C1 and center staff (see confidential names form LIC 811) denied the allegation of sexual abuse that a center staff inserted a toy car in C1's anus occurred at the facility. Parent of C1 concerned since the alleged incident happened four years ago possibly child could not recall the information properly. Therefore, the evidence does not support, nor disprove the above allegation was violated, the above allegation have been determined unsubstantiated. Unsubstantiated – A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
An exit interview was conducted with the Director. This report along with a notice of site visit, a copy of the appeal rights was via emailed to the Director. Via email with a read receipt or confirmation of receipt of email, which will act as the Director's signature.



Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
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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