191870884-8-8-2023-58-CC-RRAS-CX72LH-20231101172930

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191870884
Report Date: 08/08/2023
Date Signed: 08/08/2023 06:09:45 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
08/04/2023 and conducted by Evaluator Lilia Hernandez

PUBLIC

COMPLAINT CONTROL NUMBER: 58-CC-20230804082924

FACILITY NAME:	SHENANDOAH EARLY EDUCATION CENTER		FACILITY NUMBER:	191870884
ADMINISTRATOR:	COLLINS, CAROL		FACILITY TYPE:	850
ADDRESS:	8861 BEVERLYWOOD ST.		TELEPHONE:	(310) 838-7328
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	115	CENSUS: 18	DATE:	08/08/2023
		UNANNOUNCED	TIME BEGAN:	03:19 PM
MET WITH:	Marcello Lopez, Principal		TIME COMPLETED:	06:10 PM

ALLEGATION(S):

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Staff did not provide adequate supervision resulting in day care child
wandering away from facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced complaint inspection on 08/08/23 to investigate the above allegation. LPA arrived at the facility at 03:19 PM and met with Marcello Lopez, Principal, who guided LPA on tour of the facility. There were 18 children and 11 staff present upon arrival.

During the investigation LPA obtained a copy of children’s roster, staff schedules, took pictures, took measurements, and conducted interviews.

Information provided by the reporting party indicates that on 07/20/2023, staff did not provide adequate supervision resulting in day care child wandering away from facility.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 58-CC-20230804082924

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SHENANDOAH EARLY EDUCATION CENTER	FACILITY NUMBER: 191870884
	VISIT DATE: 08/08/2023

NARRATIVE

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Principal disclosed that child #1 indeed eloped from the facility on 07/20/2023.

Per Principal, Child #1 was signed in by Parent #1, Child#1 guardian, when Child #1 eloped.

Per Principal, Child #1 was found approximately 1436.9 feet away from the facility. (LPA took measurements)

Per principal, Parent #2 brought child back to the facility in her car.

Per Principal, Parent #2 is not Child#1 parent or guardian.

While interviewing staff, Staff #1, Staff #2 and Staff #3 disclosed that Child #1 indeed eloped from the facility. Staff #1 and Staff #3 stated that they were right behind Child#1 throughout the time child eloped. Before Staff #1 could catch up to Child#1, Parent #2 assisted Staff #1 in bring Child#1 back to the facility.
Per Staff #1, Parent #2 placed Child #1 in their car and drove child back to the facility.

Based on the investigation conducted by the Department which includes interviews, record reviews, and other pertinent information, 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 101229(a)(1) Responsibility for Providing Care and Supervision is being cited on the attached deficiency.

The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Exit interview was conducted with Marcello Lopez, Principal, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 58-CC-20230804082924

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SHENANDOAH EARLY EDUCATION CENTER	FACILITY NUMBER: 191870884
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/08/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/18/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	(a) The licensee shall provide care and supervision as necessary to meet the children's needs... Supervision shall include visual observation. This requirement was not met as evidenced by	1 2 3 4 5 6 7	Principal states that a meeting is scheduled for staff to discuss care and supervison. Principal will submit an agenda,attendance sheet and staff signatures by email to LPA by POC due date.
	8 9 10 11 12 13 14	interviews conducted and disclosures made indicating that Child #1 indeed eloped from the facility which poses an immediate health, safety, and personal rights risk to children in care.	8 9 10 11 12 13 14
	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.

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia Hernandez	TELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC9099 (FAS) - (06/04)

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