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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191606804
Report Date: 08/05/2024
Date Signed: 08/06/2024 07:10:38 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/07/2024 and conducted by Evaluator Veronica Wheatley
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20240507140852
FACILITY NAME:CHILD LANEFACILITY NUMBER:
191606804
ADMINISTRATOR:ROBERTA RAMIREZFACILITY TYPE:
830
ADDRESS:769 W. 3RD STREETTELEPHONE:
(310) 514-4999
CITY:SAN PEDROSTATE: CAZIP CODE:
90732
CAPACITY:10CENSUS: 5DATE:
08/05/2024
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Aolelani LutuTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff yells at children in care
INVESTIGATION FINDINGS:
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On 8/5/2024, Licensing Program Analyst (LPA), V. Wheatley conducted unannounced inspection and met with Site Supervisor, Aolelani Lutu regarding the above allegation. LPA observed 5 infants present and supervised appropriately.

On 05/14/2024, Licensing Program Analyst (LPA) V. Wheatley conducted an inspection regarding the above allegation. LPA met with site supervisor, Aolelani Lutu and observed 3 infants on the premises. LPA obtained a copy of facility roster, personnel report, and conducted a staff interview.

Based on the information obtained and interviews which were conducted by LPA Sarah Garcia, the preponderance of evidence standard has been met, therefore the above allegation that the Staff #1 yelled at children is found to be substantiated based on California Code of Regulations, (Title 22, Division 12 & Chapter 1). This deficiency was previously cited. Exit interview conducted. The report was read and provided to the Site Supervisor and appeal rights.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
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: 1 of 3
Control Number 30-CC-20240507140852
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHILD LANE
FACILITY NUMBER: 191606804
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/05/2024
Section Cited
CCR
101223(a)(3)
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101223 Personal Rights (a)(3)
(a) The licensee shall ensure...the following personal rights:(3) To be free from corporal or unusual punishment, infliction...including but not limited to: interference with functions of daily living including...
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Site Supervisor submitted a Plan of Correction previously and had all staff members view the videos, write down what they learned (LIC 855), and returned the information to the Department. Currently, a new program coordinator is coaching the teachers.
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This requirement was not met as evidenced by: Based on interviews and statements received, Staff 1 (S1) yelled at children in care which poses an immediate health, safety, and personal rights risk to children in care. This was previously cited.
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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: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
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: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/07/2024 and conducted by Evaluator Veronica Wheatley
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20240507140852

FACILITY NAME:CHILD LANEFACILITY NUMBER:
191606804
ADMINISTRATOR:ROBERTA RAMIREZFACILITY TYPE:
830
ADDRESS:769 W. 3RD STREETTELEPHONE:
(310) 514-4999
CITY:SAN PEDROSTATE: CAZIP CODE:
90732
CAPACITY:10CENSUS: 5DATE:
08/05/2024
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Aolelani LutuTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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9
Child sustained unexplained injury while in care
Staff did not ensure adequate supervision was provided to child in care
INVESTIGATION FINDINGS:
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On 8/5/2024, Licensing Program Analyst (LPA), V. Wheatley conducted unannounced inspection and met with Site Supervisor, Aolelani Lutu regarding the above allegation. LPA observed 5 infants present and supervised appropriately.

On 05/14/2024, Licensing Program Analyst (LPA) V. Wheatley conducted an inspection regarding the above allegation. LPA met with site supervisor, Aolelani Lutu and observed 3 infants on the premises. LPA obtained a copy of facility roster, personnel report, and conducted a staff interview.

Based on the information obtained and interviews which were conducted, the above allegations are Unsubstantiated. A unsubstantiated finding means although the allegations may have happened or are valid there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are deemed unsubstantiated. An exit interview was conducted, a copy of this report, appeal rights along with Notice of Site Visit were provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
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 3