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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020150
Report Date: 04/06/2023
Date Signed: 04/06/2023 06:36:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 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
03/29/2023 and conducted by Evaluator Seung Lee
COMPLAINT CONTROL NUMBER: 33-CC-20230329084121
FACILITY NAME:MENTOR PRESCHOOL ON LAKEFACILITY NUMBER:
198020150
ADMINISTRATOR:JASMIN MANZANEROFACILITY TYPE:
850
ADDRESS:232 N. LAKE AVE #100TELEPHONE:
(626) 437-5506
CITY:PASADENASTATE: CAZIP CODE:
91101
CAPACITY:75CENSUS: 54DATE:
04/06/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jasmin Manzanero & German Jose SalcedoTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not isolate sick day care child.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced complaint inspection. Upon arrival LPA Lee met with Director Jasmin Manzanero and Licensee German Jose Salcedo.

During the course of this inspection, LPA Lee made observations, reviewed documents, and conducted interviews in regards to the above allegation.

The complaint alleges that the facility did not isolate Child#1 after contacting the child's parent to pick up the child. The Director stated that Child#1 was allowed to participate in an activity in the outdoor play space after the parent was asked to pick up the child from the facility. The Director stated that although Child#1's parent was contacted based on the temperature taken at the facility, the child did not seem sick with a contaigous illness. The facility was having an event that day in the outdoor play space, and Child#1 was allowed to participate before being picked up by the parent.

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Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 33-CC-20230329084121
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MENTOR PRESCHOOL ON LAKE
FACILITY NUMBER: 198020150
VISIT DATE: 04/06/2023
NARRATIVE
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Although the facility determined that it was appropriate to have Child#1 participate in the outdoor activity, the parent of Child#1 had already been contacted and was on the way to pick up Child#1. Child care center regulations states that a child must be isolated when their condition worsens enough to warrant notifying the child's authorized representative. Since Child#1's parent was contacted, the child should have been isolated in the isolation area until the parent arrived to pick up the child.

Based on the evidence collected during this investigation, the preponderance of evidence has been met. Therefore, the allegation stating the facility staff did not isolate sick day care child has been substantiated.
The deficiency listed on the attached LIC 9099D are being cited in accordance with California Code of Regulations Title 22.

The notice of site inspection must remain posted for a period of 30 day during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Licensee German Jose Salcedo. Appeal rights discussed and explained.

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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20230329084121
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MENTOR PRESCHOOL ON LAKE
FACILITY NUMBER: 198020150
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/06/2023
Section Cited
CCR
101626.2(c)(1)
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A child shall be isolated when any one of the following occurs: The child's condition worsens enough to warrant notifying the child's authorized representative as specified in Section 101626(b). This requirement was not met as evidenced by the fact that Child#1 was not isolated after the parent was contacted by the facility to pick up Child#1.
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The facility stated children will be properly isolated if a parent or authorized representative is contacted and asked to pick up a child from the facility.
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This is a pontential risk to children in care.
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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: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
LIC9099 (FAS) - (06/04)
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