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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191226432
Report Date: 04/14/2025
Date Signed: 04/14/2025 02:56:33 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 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
04/07/2025 and conducted by Evaluator Shushanik Safaryan
COMPLAINT CONTROL NUMBER: 33-CC-20250407100255
FACILITY NAME:SUSANNA WESLEY CHILDREN'S CTR/INFANTFACILITY NUMBER:
191226432
ADMINISTRATOR:RENEE SPIVEYFACILITY TYPE:
830
ADDRESS:134 N. KENWOOD ST.TELEPHONE:
(818) 548-6229
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY:19CENSUS: 10DATE:
04/14/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Renee SpiveyTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Licensee is not ensuring that the facility refrigerator is in good repair.
Licensee is not ensuring that staff follow proper food safety protocols.
INVESTIGATION FINDINGS:
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On 04/14/2025, Licensing Program Analyst(LPA) Shushanik Safaryan conducted an unannounced visit regarding complaint investigation received by the Department .During the visit , LPA met with Facility Representative , Renee Spivey , to whom the purpose of the visit was explained. Facility Representative guided LPA on the tour of the facility , LPA observed 10 children with 3 staff members.

Complaint alleged that Licensee is not ensuring that the facility refrigerator is in good repair.

During the visit, LPA obtained facility roaster, took pictures, talked to the Director and staff members. During the tour LPA inspected the refrigerator in the infant room. In the refrigerator LPA observed food stored for children. LPA observed thermometer in the refrigerator showing 58 F. LPA measured the temperature with the different thermometer and observed temperature in the refrigerator 16.6 C (61.8 F).LPA opened the freezer and observed bottles of water and milk on the top shelf of the freezer. LPA measured the temperature in the freezer and observed 15.9 C (60.62).
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
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-20250407100255
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SUSANNA WESLEY CHILDREN'S CTR/INFANT
FACILITY NUMBER: 191226432
VISIT DATE: 04/14/2025
NARRATIVE
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During the interview ,staff stated refrigerator was not working and Director was notified. Director stated request for the new refrigerator or replacement was placed since December, when she noticed refrigerator does not keep cold temperature. LPA obtained email regarding request dated 12/2024. Staff stated, they continued to use the refrigerator since no other ones were available.


Complaint alleged that Licensee is not ensuring that staff follow proper food safety protocols.

During the tour, LPA observed bottles of milk and yogurt stored in the freezer. Per staff , refrigerator does not keep cold temperature and some items stored in the freezer. LPA measured the temperature in the freezer and observed temperature above 45F. (Pictures were taken).

During the visit, Director stated that replacement refrigerator will be moved from the 3rd floor and placed in the infant room.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 , Chapter 1 ), are being cited on the attached LIC 9099D.

Exit interview conducted with Facility Representative ,Renee Spivey and Appeal Rights explained.

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.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 33-CC-20250407100255
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SUSANNA WESLEY CHILDREN'S CTR/INFANT
FACILITY NUMBER: 191226432
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/18/2025
Section Cited
CCR
101227(a)(22)(C)
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101227 Food Services (a) In child care centers (22) Equipment necessary for the storage,... of food or snacks ... shall be well-maintained. Necessary equipment shall include, but not be limited to:
(C) Refrigeration.
This requirements not met evidenced by:

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Director stated replacement refrigerator will be moved from 3rd floor to an infant room ASAP. Per Director she will ensure it is working properly.
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Per staff memebers , refrigerator does not keep cold temperature.LPA observed children`s food (milk, yougurts) stored in the refrigerator and freezer at degrees above 45F. Temperature in the freezer measured at 60.62 F(15.9C) and refrigerator at 61.8 F(16.6 C).
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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: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
LIC9099 (FAS) - (06/04)
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