198018309-7-13-2021-33-CC-BBAT-C4VTKQ-20210713144819

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198018309
Report Date: 06/23/2021
Date Signed: 07/13/2021 02:48:19 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
04/26/2021 and conducted by Evaluator Bardo Baluyot

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20210426105502

FACILITY NAME:	SOUTH HILLS ACADEMY		FACILITY NUMBER:	198018309
ADMINISTRATOR:	MICHELLE CLAYTON		FACILITY TYPE:	850
ADDRESS:	1600 E. FRANCISQUITO AVE.		TELEPHONE:	(626) 919-2000
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91791
CAPACITY:	120	CENSUS:	DATE:	06/23/2021
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Director, Michelle Clayton		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff are not providing adequate supervision to daycare children.
Lack of supervision resulting in a child being injured.

INVESTIGATION FINDINGS:

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At apporximately 11:30 AM, Licensing Program Analyst (LPA) Bardo Baluyot conducted an unannounced follow up inspection to present findings on the complaint allegationsin listed above. LPA met with Administrator, Michelle Clayton who guided the LPA on a tour of the facility. LPA observed 51 children present, ranging from ages 2-5 in their respective classrooms. Staff to student ratio was observed to be adequate in all six classrooms. Based on Interviews conducted by the LPA, there were consistent statements that staff does adequately supervise daycare children. However, all staff interviewed were not able to provide any explanation of how Child #1 sustained an injury while engaged in a group dance activity. During the interview with Child # 1, he stated that Child #2 punched him in the chin and nose. However, there were no other disclosures made throughout the course of the investigation and there were no eyewitnesses who could identify or explain who injured Child #1. Pictures provided on the day of the incident confirm that staff was near or around the children while children engaged in the activity. LPA Baluyot was the officer on duty when Director Clayton called in the unusual incident report on 4/26/21.
PG 1 of 1

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021

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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Control Number 33-CC-20210426105502

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: SOUTH HILLS ACADEMY	FACILITY NUMBER: 198018309
	VISIT DATE: 06/23/2021

NARRATIVE

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During a subsequent interview, LPA asked Director Clayton why she stated in her report that the child was in fact “hit”. Director Clayton admitted that “they just assumed” that he was hit during the activity despite no actual witness of such an event occurring and because parent of Child #1 was insistent that his son was punched according to his son’s own account of the incident. Per Parent #1, Child #2 was also involved in a previous incident where he bit Child #1. LPA interviewed staff, students and parents regarding whether or not Child #2 exhibited patterns of aggression including biting and hitting. All statements obtained support that Child #2 has not and does not exhibit patterns of bullying and/or aggression since the biting incident in December.

Allegations regarding Lack of supervision: Child had a bloody nose and staff was unsure of who or what caused the nosebleed. During the course of the investigation, Parent #1 stated that Parent #2 observed blood on the inside of the child’s mask after picking him up at the end of the school day (4/23). Child #1’s parents and relatives posted photos and details of the incident on social media. LPA reviewed reports pertaining to the incident. Though local police were contacted, parents of Child #1 were informed that the complaint did not warrant a police report. Per Interviews, no staff or children witnessed Child #1 actually getting hit or punched but stated that they had only heard in the days following that hitting or punching was the cause of the nosebleed. Staff acknowledged that child’s nose bled and that child’s mask did in fact have drops of blood but assumed that it was due to child being accidentally hit while dancing or that the child himself could have caused his nose to bleed by rubbing it due to dryness. Staff also stated that an incident report was not created until the following Monday, as they were not aware that there had been punching or hitting involved as Child #1 did not communicate that any such incident occurred. Per staff, they only became aware that they had a “situation” when the child’s father arrived at the school on Monday, 4/26.

Based on the information obtained, Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

PG 2 OF 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 33-CC-20210426105502

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: SOUTH HILLS ACADEMY	FACILITY NUMBER: 198018309
	VISIT DATE: 06/23/2021

NARRATIVE

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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Michelle Clayton Administrator, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

This an amended version of report issued to the facility on 06/23/2021 to reflect it is a public document.

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END OF REPORT

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo Baluyot	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

LIC9099 (FAS) - (06/04)

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