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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191806528
Report Date: 03/05/2025
Date Signed: 03/05/2025 12:43:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 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
12/23/2024 and conducted by Evaluator Saul Valenzuela
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20241223121509
FACILITY NAME:CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)FACILITY NUMBER:
191806528
ADMINISTRATOR:LAURA HERNANDEZFACILITY TYPE:
850
ADDRESS:4601 SUNSET BOULEVARDTELEPHONE:
(323) 361-4601
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY:89CENSUS: 29DATE:
03/05/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Marife Adriano, Site SupervisorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not meet day care child's needs.
Staff did not allow day care child into the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced subsequent inspection of a complaint investigation. Upon arrival at 9:15 a.m., LPA was met by Marife Adriano, to whom the purpose of the inspection was explained. Tour of the facility was provided. There were 29 children present during the time of inspection.

During the course of the investigation, Interviews were conducted with five (5) staff, two (2) children, and four (4) parents. LPA obtained documentation included but not limited to children roster (LIC 9040), Personnel Report (LIC 500), email threads, declaration form and copies of documentation in the file for Child #3.

According to the allegation, Staff did not meet day care child's needs.

REPORT CONTINUES PAGE 1 of 3
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 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
12/23/2024 and conducted by Evaluator Saul Valenzuela
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20241223121509

FACILITY NAME:CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)FACILITY NUMBER:
191806528
ADMINISTRATOR:LAURA HERNANDEZFACILITY TYPE:
850
ADDRESS:4601 SUNSET BOULEVARDTELEPHONE:
(323) 361-4601
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY:87CENSUS: 29DATE:
03/05/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Marife Adriano, Site SupervisorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
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5
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9
Staff did not ensure facility was operating in ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Saul Valenzuela conducted an unannounced subsequent inspection of a complaint investigation. Upon arrival at 9:15 a.m, LPA was met by Site Supervisor Marife Adriano, to whom the purpose of the inspection was explained. Tour of the facility was provided. There were 29 children present during the time of inspection.

During the course of the investigation, Interviews were conducted with five staff and two children. LPA obtained documentation included but not limited to children roster (LIC 9040), Personnel Report (LIC 500), email threads, declaration form and copies of documentation in the file for Staff #6.

According to the allegation, Staff did not ensure facility was operating in ratio.

REPORT CONTINUES PAGE 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 33-CC-20241223121509
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)
FACILITY NUMBER: 191806528
VISIT DATE: 03/05/2025
NARRATIVE
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During interviews, there were no disclosures by staff or parents regarding staff not ensuring facility was operating in ratio. Per staff, the administration will assist in classrooms if needed. Site Supervisor corroborated that administration staff would assist in maintaining ratio in the classrooms when they are low on staffing. According to Site Supervisor that every staff employed by the school is a fully qualified teacher.

During record review, LPA Valenzuela reviewed Staff #1-#6 files to ensure that staff are fully qualified to provide care to children. LPA observed that Staff #1- #6 are qualified to provide care to children at the school and have at least one staff that has Pediatric CPR / Firs Aid.

LPA consulted with Site Supervisor that clerical staff shall not be included as teachers in the teacher-child ratio. LPA obtained a Declaration form from Marife Adriano stating that clerical staff will be used as emergency substitutes while a teacher is being secured.

This agency has investigated the complaint alleging staff did not ensure facility was operating in ratio. Based upon the evidence as presented above, the allegation have been determined to be Unsubstantiated. A finding of Unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove alleged violation(s) did or did not occur, therefore at this time the above allegations are unsubstantiated.

There were no deficiencies cited on the above-mentioned allegation per California Code of Regulations Title 22.

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 and report was reviewed with Site Supervisor Marife Adriano. Copy of Report provided.

END OF REPORT PAGE 2 of 2
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 33-CC-20241223121509
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)
FACILITY NUMBER: 191806528
VISIT DATE: 03/05/2025
NARRATIVE
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During interviews, staff disclosed that they follow behavior management guidelines set by leadership at the school when staff are trying to meet the child’s needs. Per staff, that during initial welcome meeting that they verbally discuss the expectations with parents. Per Site Supervisor, that if a challenging behavior is progressing that parents will be notified, and meeting will be scheduled. Parent #4 (P4) disclosed that the school has given them notice that if they did not provide services to their child that they would be let go from the school. Per P4, they “think it was lack of process like let’s meet and I did state in an email that it’s inconsistent”. Parent #3 and Parent #4 disclosed that they have not received a parent handbook at the time of enrollment. Site Supervisor stated that the parent handbook was in a written draft form and is currently with leadership for review.

During record review, LPA Valenzuela asked Site Supervisor if LPA can obtain a copy of the Behavior Management Guidelines and Parent Handbook. According to Site Supervisor that the documents are currently with “leadership”. LPA Valenzuela observed that there were no current admission agreement and parent handbook in Child #1-4 files outlining the current individual written admission agreement between the parents and the facility. According to Site Supervisor that Admission Agreement was updated on 9/2024.LPA observed Child #1-#4 did not have the updated Admission Agreement on file.

According to the allegation, Staff did not allow day care child into the facility.

During interviews, staff disclosed that children were not allowed to return to school due to the school exhausting their resources to support the child in care. Per Site Supervisor that that the children that were not allowed to return to school was for the safety of the other children, that parents are verbally notified of the “expectations and understand the type of protocol that they have”. Per P4, the school stated that if P4 did not receive any “help” for their child that they would be let go from school. Staff corroborated that conversations with parents were conducted verbally.

REPORT CONTINUES PAGE 2 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 33-CC-20241223121509
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)
FACILITY NUMBER: 191806528
VISIT DATE: 03/05/2025
NARRATIVE
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During record reviews, LPA observed that Child #1-#4, did not have the updated admission agreement in their files nor receipt of a Parent Handbook. LPA observed that Enrollment Agreement in Child #1-#4 states that additional information can be found in the Parent Handbook, however Site Supervisor stated that Parent Handbook have not been provided to parents as the handbook is currently with "leadership" for approval. LPA did not observe documentation in children records that outlines that the school has assess whether they can meet the child's needs prior to enrollment.

Based on interviews and record reviews conducted by the LPA and the staffs’ own statements, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & chapter 1), are being cited on the attached LIC 9099D.



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.

An exit interview conducted, and the report was reviewed with Facility Representative, Marife Adriano.

END OF REPORT PAGE 3 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 33-CC-20241223121509
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CHILDREN'S HOSPITAL CHILD DEVELOPMENT CENTER (PS)
FACILITY NUMBER: 191806528
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2025
Section Cited
CCR
101219(a)
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101219 Admission Agreements
(a) The licensee and the child's authorized representative shall jointly complete a current individual written admission agreement for the child...
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Licensee will provide LPA a copy of the updated parent handbook.
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Based on LPA’s interviews and record reviews conducted on C1, C2, C3, and C4 did not have a current individual written admission agreement for review. This poses a potential health and safety risk to 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: Brandi VanOosten
LICENSING EVALUATOR NAME: Saul Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6