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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191204631
Report Date: 08/05/2024
Date Signed: 08/05/2024 10:32:52 AM

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
07/11/2024 and conducted by Evaluator Anomeh Eivazian
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240711130304

FACILITY NAME:SUSANNA WESLEY CHILDREN'S CENTERFACILITY NUMBER:
191204631
ADMINISTRATOR:RENEE SPIVEYFACILITY TYPE:
850
ADDRESS:134 N. KENWOOD ST.TELEPHONE:
(818) 548-6229
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY:12CENSUS: 6DATE:
08/05/2024
UNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Renee Spivey, DirectorTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff are not ensuring play items are properly maintained
Staff are not following the disaster and mass casualty plan
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection to the above facility delivering above allegations findings. LPA arrived at 8:20 a.m. on 08/05/24 and met with Guadalupe Castillobarcena, teacher. At 9:00 a.m., Renee Spivey, director arrived to the facility who guided analyst on a tour of the facility. During this inspection there were 6 preschoolers present in the facility with two staff. There is an infant program in the facility address with facility number 191226432.

During this investigation, LPA Eivazian conducted interviews with two staff. LPA obtained a copy of current facility roster. LPA obtained copies of July and August Newsletters.

Based on staff#1 and staff#2, last fire drill was conducted over 6 months ago. Per staff#1, all staff will be in professional development training in August 2024 to be retrained on how to conduct a fire drill and next fire drill will be conducted in August 2024.
REPORT CONTINUES ON NEXT PAGE 1 of 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 33-CC-20240711130304
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: SUSANNA WESLEY CHILDREN'S CENTER
FACILITY NUMBER: 191204631
VISIT DATE: 08/05/2024
NARRATIVE
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Per staff#1 and staff#2, one children buggy was missing front seat safety handle but had seat belts. Also, one children buggy front wheel was not working properly in a way that staff#2 was not able to turn that buggy smoothly.

Based on LPA Eivazian observation and record review on 07/15/24, facility did not conduct fire drill every six months as it is required. LPA observed three children buggies were parked outside the preschool classroom in the hallway. LPA observed one of the buggy was missing the front seat safety handle and one buggy front wheel was not working properly in a way that staff#2 was only to move that buggy front and back and was not able to turn that buggy smoothly.

Based on LPA observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been meet, therefore the above allegations are found to be Substantiated at this time. Title 22 Code 101174(d)--Disaster and Mass Casualty Plan--Disaster drills shall be conducted at least every six months and 101239(n)--Fixtures, Furniture, Equipment and Supplies Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts are being cited on the attached LIC9099D.


The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the director, Renne Spivey.
REPORT END 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20240711130304
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: SUSANNA WESLEY CHILDREN'S CENTER
FACILITY NUMBER: 191204631
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2024
Section Cited
CCR
101174(d)
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101174(d)--Disaster and Mass Casualty Plan
Disaster drills shall be conducted at least every six months.
This requirement was not met as evidenced by...
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Per director, all staff will be retained on how to conduct fire drill in August 2024 and a fire drill will be conducted by plan of correction due date.
Director will submit a copy of fire drill log to LPA Eivaizan via email by 08/16/24.
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Per staff#1, facility did not conduct Fire drill every six months as it is required.

This is a potential health, safety and personal right risk to the children in care.
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Type B
08/05/2024
Section Cited
CCR
101239(n)
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101239(n)--Fixtures, Furniture, Equipment and Supplies
Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.
This requirment was not met as evidenced by...
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On 08/05/24: LPA observed director purchased two brand new buggies and it was parked in the hallway of classrooms and working properly.

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Based on staff#1 and staff#2 interviews, one buggy was missing front seat safety handle and one children buggy front wheel was not working properly, and staff#2 was not able to turn that buggy.
This poses a potential health, safety and personal right risk to the 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.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5