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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191601818
Report Date: 09/28/2023
Date Signed: 09/28/2023 04:07:04 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/20/2023 and conducted by Evaluator Randy Derraco
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20230720134334
FACILITY NAME:DOROTHY AHRENS NURSERY SCHOOLFACILITY NUMBER:
191601818
ADMINISTRATOR:AHRENS-SALLEY,NANCYFACILITY TYPE:
850
ADDRESS:4960 LONG BEACH BLVDTELEPHONE:
(562) 423-3880
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:63CENSUS: 33DATE:
09/28/2023
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Owner - Nancy AhrensTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Staff caused injury to daycare child
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced complaint inspection to the above mentioned facility on 09/28/23. LPA arrived at the facility at 01:20 PM and was met by Nancy Ahrens, owner, who guided analyst on a of the facility. LPA observed 33 children in care and 5 adults supervising the children. LPA observed the center to be clean and free of defects.

During the course of the investigation, LPA conducted interviews, reviewed records, and made observations. Interviews conducted confirm that while covering a break for Staff #5 (S5), Staff #2 (S2) poked a child in the arm with pine needles from a pine tree that is located in the playground. Interviews conducted also confirm that the pine needles were taken out of the child's hand by grabbing his arm while the child was poking other children in care. S5 confirmed that she grabbed the pine needles out of S2's hand and threw them in the trash.

Based on the LPA's observations and interviews conducted, the preponderance of evidence standard has
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
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 54-CC-20230720134334
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: DOROTHY AHRENS NURSERY SCHOOL
FACILITY NUMBER: 191601818
VISIT DATE: 09/28/2023
NARRATIVE
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been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulation Title 22, Division 12, Chapter 1, Article 6, Section 101223(a)(3) is being cited on the attached LIC 9099D

LPA R. Derraco informed licensee Nancy Ahrens that this report dated 09/28/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA R. Derraco informed the licensee Nancy Ahrens to provide a copy of this licensing report dated 09/28/23 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit 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, appeal rights provided, and report was reviewed with the licensee Nancy Ahrens

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20230720134334
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: DOROTHY AHRENS NURSERY SCHOOL
FACILITY NUMBER: 191601818
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/29/2023
Section Cited
CCR
101223(a)(3)
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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse...This requirement is not met as evidenced by:
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Licensee will require S2 to take online courses using website www.continued.com on how to deal with children exhibiting challenging behavior. Licenseel states S2 will continue to have a teacher aide in the classroom at all times. Licensee will email LPA a copy of the completion certificate.
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Based on observation, interview and record review, the S2 did not ensure each child to be free from coporal or unusual punishment which poses an immediate Health, safety and/or personal rights risk to persons 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: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3