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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191596178
Report Date: 08/23/2022
Date Signed: 08/23/2022 03:55:27 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
08/15/2022 and conducted by Evaluator Jennifer Hua
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20220815153050
FACILITY NAME:CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191596178
ADMINISTRATOR:TAMIKA ADDISONFACILITY TYPE:
830
ADDRESS:1100 N. GRAND AVE. BLDG. 70TELEPHONE:
(909) 274-4920
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY:69CENSUS: 21DATE:
08/23/2022
UNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Tamika Addison & Lupe HernandezTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility does not ensure a safe and healthful environment for children by not providing safe play equipment
Facility has an insect infestation
INVESTIGATION FINDINGS:
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Complaint investigation conducted by Licensing Program Analyst Jennifer Hua. LPA met with Director Tamika Addison and Assistant Director, Lupe Hernandez. A Covid-19 Risk assessment was conducted prior to entry. Director and assistant director took LPA on a tour of the facility. There are a total of 3 classrooms for the infant program. LPA observed there were 21 children in care supervised by 11 staff. LPA reviewed the allegations with Director and assistant director.

Interviews conducted with director, assistant director and staff

Director and assistant director stated that they were not aware that the slide in the front of the T2 classroom was too hot for children to go on, because it was not reported to them by staff. Staff inerviewed confirmed that in the afternoon, the bigger slide gets too hot and they will spray water on the slide with a spray bottle to cool it down but the slide is still hot, and children are not allowed to go on the slide. LPA inspected the playground equipment outside the T2 classroom and observed the bigger plastic slide is hot to touch and there is no canopy over the slide.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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-20220815153050
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: CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191596178
VISIT DATE: 08/23/2022
NARRATIVE
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Director, assistant director and staff confirmed that last week, there was an infestation of ants through out the facility and the infestation was addressed immediately. Director, assistant director and staff stated that there was no infestation of spiders. LPA checked the perimeter of the facility, the main kitchen, the classrooms, the kitchenettes and observed no ant infestation at this time.

This agency has investigated the complaint alleging facility does not ensure a safe and healthful environment for children by not providing safe play equipment and facility has an insect infestation. Based on LPA's observation and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. California Code of Regulations, Title 22 are being cited on the attached LIC 9099Ds.

An exit interview conducted with director and assistant director, copy of the report given. Notice of Site Visit Form was provided and explained. The notice shall be posted for 30 days in an area accessible for review. Appeals Rights were provided.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 33-CC-20220815153050
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: CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191596178
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/24/2022
Section Cited
CCR
101239(o)(1)
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Fixtures, Furniture, Equipment and Supplies. Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts. The requirement is not met as evidenced by. Based on interviews conducted with staff, in the afternoon, the bigger plastic slide gets too hot to the touch and children are not able to
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A canopy was installed over the slide during the visit to ensure the slide will not get too hot.

Deficiency corrected during visit.
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use the slide. This poses a potential risk to the health and safety of children in care.
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Type B
08/24/2022
Section Cited
CCR
101238(a)1)
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Buildings and Grounds. The licensee shall take measures to keep the center free of flies, other insects, and rodents. The requirement is not met as evidenced by: Staff confirmed that there was an infestation of ants last week. This poses a potential risk to the health and safety of children in care.
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Per director and assistant director, the infestation was addressed immediately and infestaion is no longer an issue.

Deficiency has been corrected.
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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: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3