<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020251
Report Date: 06/24/2024
Date Signed: 06/24/2024 04:08:44 PM

Substantiated


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
06/18/2024 and conducted by Evaluator Monique Jessica Ayala
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240618165025
FACILITY NAME:HAPPY BIRCH PRESCHOOLFACILITY NUMBER:
198020251
ADMINISTRATOR:MALI RANDFACILITY TYPE:
850
ADDRESS:1423 TAMARIND AVETELEPHONE:
(323) 469-3706
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY:46CENSUS: 31DATE:
06/24/2024
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Mali Rand, Director TIME COMPLETED:
04:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights: Staff handled child in a rough manner
Reporting Requirements: Staff did not follow reporting requirements
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On June 24, 2024, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced complaint investigation for the above allegations. A COVID-19 risk assessment was conducted prior to entering the facility. LPA met with director, Mali Rand who guided LPA on a tour of the facility. LPA observed 31 children in care.

During the investigation, LPA interviewed Staff #1 (S1) to Staff #3 (S3), interviewed Child #1 (C1) to Child #3 (C3), reviewed video footage of the incident and obtained a current facility roster. LPA interviewed Reporting Party (RP).

RP alleged, "Staff handled child in a rough manner". RP stated that S1 grabbed a C1 roughly today (06/18/2024) and made C1 cry in front of the class. LPA interviewed S1 who stated she observed the footage and understands how the video may seem like C1 was handled in rough manner but that was not S1 intention.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
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 4
Control Number 33-CC-20240618165025
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: HAPPY BIRCH PRESCHOOL
FACILITY NUMBER: 198020251
VISIT DATE: 06/24/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA interviewed S2 and S3 who stated there have been multiple occasion where S1 is rough with the children in classroom and has yelled at the children in classroom. LPA reviewed and obtained video footage of the incident and observed S1 to yell at C1 three times to return a toy to another child. LPA observed S1 stand from her chair and walk towards to C1, S1 grabbed the toy from C1 hand and S1 grabbed C1's arm to sit on a chair.

RP alleged, "Staff did not follow reporting requirements". RP stated, that S1, did not tell the parent of C1 what happened during pick up. Per director, S1 notified parent of C1 but there was no written report. However, the facility director never reported this incident to the department as required by Title 22 Regulations. Per director she did not know that the report needed to be reported to the department.

Based on interviews conducted and review of video footage the above allegations are deemed SUBSTANTIATED. LPA observed the video footage of the incident where C1 was being yelled at and was grabbed to be placed on a chair. A finding of Substantiated means that the preponderance of evidence standard has been met. The facility is being cited a Type A and a Type B deficiency in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06, Section 101223(a)(2) "Personal Rights” is being cited on the attached LIC 9099D and Section,

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee/Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form (LIC9224) during this visit. A copy of the Parent Notification Requirements was also provided to the Director

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.

An exit interview was conducted and a copy of this report was provided to the director, Mali Rand along with Appeal Rights.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 33-CC-20240618165025
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: HAPPY BIRCH PRESCHOOL
FACILITY NUMBER: 198020251
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/20/2024
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
Personal Rights: The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidence by: Based on interviews and video
1
2
3
4
5
6
7
Per director a staff meeting was held on 06/20/2024 reviewing Personal Rights and discussion the incident that occurred.
8
9
10
11
12
13
14
footage review, C1 was handled in a rough manner by S1 who first yelled at C1 three times, a toy was pulled away from C1 by S1 and C1 was grabbed and sat on a chair by S1. This poses an immediate health and safety risk for 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.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 33-CC-20240618165025
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: HAPPY BIRCH PRESCHOOL
FACILITY NUMBER: 198020251
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2024
Section Cited
CCR
101212(d)(1)(C)
1
2
3
4
5
6
7
Reporting Requirements: Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours... This requirement
1
2
3
4
5
6
7
Dirctor will submit report to the department by POC date (06/28/2024).
8
9
10
11
12
13
14
was not met as evidence by: Based record review and director disclosure, the incident was not reported to the department. This poses a potential and health and safety 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.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4