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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191870577
Report Date: 08/08/2025
Date Signed: 08/08/2025 03:20:41 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
06/23/2025 and conducted by Evaluator Ashley Calderon
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20250623122242

FACILITY NAME:WILLOWBROOK CHILD DEVELOPMENT CENTERFACILITY NUMBER:
191870577
ADMINISTRATOR:LUCY BRYANTFACILITY TYPE:
850
ADDRESS:12829 SO. JARVIS AVE.TELEPHONE:
(310) 352-4486
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY:73CENSUS: DATE:
08/08/2025
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH: Secretary Kartherine Castillo and Erynn Laurent TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff are not following the sign in/out procedure
INVESTIGATION FINDINGS:
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Licensing Program Anaylst (LPA) Ashley Calderon conducted a unannounced complaint inspection at the above facility to deliever findings. LPA met with Secretary Kartherine Castillo, LPA disclosed purpose of today's visit.

During today's visit LPA Calderon conducted a tour of the facility alongside Site Supervisor Lucy Bryant
when L.Bryant arrived at the facility, LPA disclosed purpose of visit. Facility in complaince with ratio.

Regarding allegation: Staff are not following the sign in/out procedure, Based on record review LPA Calderon on 6/27/25 obtained Sample Daily Sign In and Out sheet, that indicates procedure if a child is absent staff put an A for Absent in the time in section and they cross out the date through the sheet in red pen and parents signature is to sign space. Child #1 sign in / out sheet shows red cross out pen on absent dates with 'parent signatures' althrough child has not returned since May 13, 2025.
(cont..)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
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 54-CC-20250623122242
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: WILLOWBROOK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191870577
VISIT DATE: 08/08/2025
NARRATIVE
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On case notes received for Child #1 teacher on 5/30/25 stated " I signed for the absences for the rest of May since mom never indicated any proof/ signs of disenrollment.' On 5/30/25 case notes indicate staff whom signed absences was told by Site Supervisor 'not to sign for mom from now on.' On 7/2/25 LPA received Case Notes via email from Erynn Laurent Program Manager (EL) , indicating EL spoke to Staff #1 to inform them on how to properly fill out the sign in and out sheet for children absences. Staff #1 via telephonically on 7/3/25 informed LPA Calderon S1 did a mistake to sign the mothers name indicating their absences.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted with Site Supervisor Lucy Bryant. The Notice of Site Visit must be posted for 30 days.

(End of page)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 54-CC-20250623122242
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: WILLOWBROOK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 191870577
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/08/2025
Section Cited
CCR
101229.1
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In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following...
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Facility will develop a plan in writting on how to fill out a sign in and out sheet when children parents are unable to sign. Plan will be sent to LPA Calderon by POC due date.
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The requirement was not met as evidenced by:
Case notes on 5/30/25 stated " I signed for the absences for the rest of May since mom never indicated any proof/ signs of disenrollment.' On 7/2/25 LPA received Case Notesfrom Erynn Laurent ?tilte? (EL) , states EL spoke to Staff #1 to inform them on how to properly fill out the sign in and out sheet for children absences. Staff #1 via telephonically on 7/3/25 informed LPA Calderon S1 did a mistake to sign the mothers name indicating their absences.
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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: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5