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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191500330
Report Date: 09/03/2024
Date Signed: 09/03/2024 03:38:22 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
08/29/2024 and conducted by Evaluator Mary Silva
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240829130153
FACILITY NAME:WALNUT SCHOOL HEAD START/STATE PRESCHOOLFACILITY NUMBER:
191500330
ADMINISTRATOR:ELLIS, JERRI & MCDONOUGHFACILITY TYPE:
850
ADDRESS:4701 WALNUT ST.TELEPHONE:
(818) 962-3311
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:45CENSUS: 12DATE:
09/03/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Program Manager Nancy SanchezTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Due to lack of supervision, child left the day care unassisted
INVESTIGATION FINDINGS:
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On 09/03/24, Licensing Program Analyst (LPA) Mary Silva conducted an unannounced complaint inspection to investigate the above allegations and deliver findings. LPA met with Program Manager Nancy Sanchez, and Daisy Avelar Education Supervisor, who guided LPA on a tour of the facility. The purpose of the inspection was explained. Census was taken, there was a total of 12 children present with one teacher and one teacher assistant in room #2. Per director there are 12 children enrolled in room #2. This is a Head Start program located on the campus of Walnut Elementary School in a bungalow. The Head start program has two classrooms. Room #1 and Room # 2, both classes rooms have one session 8:00AM to 11:30 AM. On August 15-Augst 30th the session was from 8:00am-10:00am.

Complainant alleged: due to lack of supervision; child left the day care unassisted.

______________________Page 1______________________________
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
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-20240829130153
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: WALNUT SCHOOL HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 191500330
VISIT DATE: 09/03/2024
NARRATIVE
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During this inspection LPA conducted interviews with a total of three staff, Program Manager, and parent of child #1. LPA reviewed staff #1 file, reviewed file for child #1, obtained copies of facility roster, IEP for child#1, sign in and sign out record, declaration from staff #1, photographs of the route were the incident occurred, photographs were parents gain entry during pick up and drop off and photographs of the classroom #2 exit doors. LPA was not able to interview child #1 as child is nonverbal.

According to interviews conducted, the incident occurred on August 28th 2024, at approximately 9:56am child#1 walked out of classroom #2 during dismissal. Per teacher #1 interview, teacher noticed child#1 was missing around 9:56am. Teacher was in the carpet area giving two children sticker as they were being dismissed and teacher looked up noticed child #1 was no longer playing in the block area. Immediately following, teacher #1 asked substitute assistant if child #1 had been picked up and substitute assistant answered no. Teacher #1 begin to search for child in the bathroom located in the classroom area and walk to room #1 which is separated by a kitchenette to search for child #1. Teacher #1 proceeded to search for child outdoors, in the area by the entry where parents gain access to enter HeadStart and didn’t see child #1. As teacher #1 was returning to classroom #2 they approached parent and informed child #1 was missing. Per teacher #1 child was missing for a total of 5 minutes. Based on interview with parent, facility staff and parent began to search for child#1. Parent found child in the playground behind the classroom #2 utilized by the kindergarten program. Based on LPA’s observations child was found 72 feet from the classroom #2.

Per parent, child was found within 3 minutes-5 minutes of their arrival to the headstart. Per sign out application, called Child Plus parent signed out child at 10:09am after meeting with teacher #1. Per program manager this was an isolated incident.



This agency has investigated the complaint alleged: due to lack of supervision child left the day care unassisted. Based on interviews conducted, photographs taken, and information gathered during this investigation. There was evidence found to corroborate the alleged allegation. The preponderance of evidence standard has been met, therefore, the above allegations are found to be substantiated. California Code of Regulations (Title 22 Division & Chapter), are being cited on the attached deficiencies page LIC 9099-D.

At this time, a Type-A deficiencies are being cited for lack of supervision. (See 809-D page) Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 33-CC-20240829130153
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: WALNUT SCHOOL HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 191500330
VISIT DATE: 09/03/2024
NARRATIVE
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Upon receipt of this report, the licensee shall post any licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will provide copies to the parents of the children in care for up to one year. A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was explained and provided to the program manager. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was reviewed and appeal rights provided to Program Manager, Nancy Sanchez.

_____________________________Page 3______________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 33-CC-20240829130153
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: WALNUT SCHOOL HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 191500330
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
09/03/2024
Section Cited
CCR
101229(a)(1)
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(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1)No child(ren) shall be left without the supervision of a teacher at any time...
This requirement was not met evidenced by:
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Per program manager barriers have been placed on both exits of the classroom. Barriers will remain during dismissal. Children will be dismissed upon parent's signature upon departure. In addition, facility will add safety rules to the lesson plan. Per program manager and Teacher #1, child will continue to learn about safety protocols. Per program manager on September 20th 2024 a training will be offered to all Headstart staff around care and supervisor. Facility will provide copy sign in sheet and agenda.
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Based on interviews conducted, LPA's observations and evidence gathered. Child #1 exited classroom #2 on 08/28/24 during dismissal. Based on interviews conducted, the facility did not comply with the section cited above as evidenced by disclosures made during department interviews, which poses an immediate health, safety, and personal rights of 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: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4