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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020251
Report Date: 07/23/2024
Date Signed: 08/15/2024 02:34:56 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
07/18/2024 and conducted by Evaluator Monique Jessica Ayala
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240718140249
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: 35DATE:
07/23/2024
UNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Mali Rand, DirectorTIME COMPLETED:
12:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Other: Parent not given substantiated report
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**This is an Amended report created on 08/15/2024 by Licensing Program Analysts (LPAs) Monique Ayala and Priscilla Ochoa.**

On July 23, 2024, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced complaint investigation for the above allegation. 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 35 children with 6 staff.

During the investigation LPA reviewed five children files, interviewed Staff #1 (S1) to Staff #2 (S2) and obtained a copy of the facility roster. LPA was unable to interview the Reporting Party (RP); LPA left the RP a voicemail with LPA's call back information. LPA interviewed Parent #1 (P1).

RP alleged, "Parent not given substantiated report".
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
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 2
Control Number 33-CC-20240718140249
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: 07/23/2024
NARRATIVE
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LPA reviewed five children files that have the signed Acknowledgement of Receipt of Licensing Reports Form (LIC9224). LPA interviewed S1-S2 who stated that parents were provided a copy of the licensing report and signed the LIC9224.

Per S1, Parent #1 (P1) was given a copy of the substantiated report and did not sign the LIC9224. Per S1, she was unaware that P1 did not share the information with Parent #2 (P2). Per S1, when she was made aware that P1 did not share the information of the substantiated complaint S1 gave P2 a copy of the report but did not sign the LIC9224. Per S2, she observed S1 provide all parents a copy of the licensing report and LIC9224. LPA Ayala was in contact with P1 who stated a copy of the substantiated complaint was never provided to P1 and the LIC9224 was not provided. LPA provided a copy of the substantiated complaint to P1 via email.

Based on interviews conducted and file review the above allegation is deemed Substantiated. A finding of Substantiated means that the preponderance of evidence standard has been met. Per P1 she stated to have never received a copy of the substantiated complaint which corroborates with the RP’s allegation. The facility is being cited a Type B deficiency in accordance with Title 22 Regulations section, 101218.1(b)(4). The deficiency will be cited on a Case Management report dated 08/15/2024. The facility was previously given a Technical Assistance for the violation, that has now been upgraded to a deficiency.

An exit interview was conducted with the director, Mali Rand along with Appeal Rights. A Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2