<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191806026
Report Date: 03/23/2023
Date Signed: 03/23/2023 04:52:18 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
03/16/2023 and conducted by Evaluator Mireya Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20230316094236

FACILITY NAME:GREGORY PARK HEAD START/STATE PRE SCHOOLFACILITY NUMBER:
191806026
ADMINISTRATOR:MARCIE HOUCHENFACILITY TYPE:
850
ADDRESS:5807 GREGORY AVE.TELEPHONE:
(323) 463-3061
CITY:LOS ANGELESSTATE: CAZIP CODE:
90038
CAPACITY:60CENSUS: 45DATE:
03/23/2023
UNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Samira Alvarez, Head Start Child Development SupervisorTIME COMPLETED:
04:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility gate is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Mireya Garcia and Mary Silva conducted an unannounced complaint inspection to investigate the above allegations. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with Head Start Child Development Supervisor, Samira Alvarez who guided LPA on a tour of the facility. Census was taken.

During this investigation, LPAs obtained a copy of Children’s roster dated 01/23/23, 01/26/23, 02/6/23, 03/01/23, 03/20/23, an LIC 855 Declaration was obtained from Staff #1, staff written statements from Staff #1 and Staff #2, Staff #3 qualification documenation, service repair order for gate dated 03/23/2023, pictures and video of the self-latch gate were taken and conducted interviews with Supervisor, two (2) day care staff, one (1) day care parent and three (3) day care children.
Report continues on next page 1 of 2.





Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
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 5
Control Number 33-CC-20230316094236
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: GREGORY PARK HEAD START/STATE PRE SCHOOL
FACILITY NUMBER: 191806026
VISIT DATE: 03/23/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Pertaining to the allegation of facility gate is in despair, Staff #1 disclosed that on March 13, 2023 during outside play time child #1 open the facility gate and ran out of the facility. Staff #1 observed when child grab the gate handle and open it. Staff #1 ran after child and was able to grab child outside of the gate. Staff #1 disclosed child was outside gate alone on the sidewalk by the entrance gate for less than 4 seconds. Staff #1 states, child was able to open door since self-closing latch was not working properly. Interview with Supervisor confirm incident took place at the facility.

Based on LPAs inspection of the gate LPAs observed self-closing latch is not working properly (pictures and video were taken).

Based on LPAs observation, interviews which were conducted, and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, the following deficiency is being cited (see attached 9099D).

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). Acknowledgement of Receipt (LIC 9224 form) must be maintained in each child’s file immediately upon receipt from parent. Child Development Supervisor, Samira Alvarez was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form (English/Spanish).

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Samira Alvarez. Report ends here page 2 of 2.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20230316094236
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: GREGORY PARK HEAD START/STATE PRE SCHOOL
FACILITY NUMBER: 191806026
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/24/2023
Section Cited
CCR
101238(a)
1
2
3
4
5
6
7
101238 Buildings and Grounds: (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by
1
2
3
4
5
6
7
Per Supervisor, a service repair order has been placed on this date and provided LPAs with a copy of the service order. Per Supervisor self-closing latch will be inspected and evaluated for repair to ensure that self-latch is closing and working properly.
8
9
10
11
12
13
14
Based on LPA's observation and Staff #1 disclosure that on March 13, 2023 during outside play time child #1 open the facility gate and ran out of the facility. Staff #1 states, child was able to open door since self-closing latch was not working properly. This poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14
In addition, the gate intercom pad will also be repair. CD Supervisor will send pictures and video of the repairs to LPA Garcia by POC due date 03/24/23.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5