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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191870897
Report Date: 12/14/2022
Date Signed: 12/14/2022 12:08:10 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 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
11/09/2022 and conducted by Evaluator Tiffanie Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20221109154618
FACILITY NAME:USC HEAD STARTFACILITY NUMBER:
191870897
ADMINISTRATOR:JOANNA WILLIAMSFACILITY TYPE:
850
ADDRESS:741 WEST 27TH STREETTELEPHONE:
(213) 743-2466
CITY:LOS ANGELESSTATE: CAZIP CODE:
90007
CAPACITY:119CENSUS: 85DATE:
12/14/2022
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Leticia RodriguezTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Qualification-Staff do not meet the qualifications to care and supervise children in care
INVESTIGATION FINDINGS:
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About 8:30 AM, Licensing Program Analyst (LPA), T. Tran arrived at the above facility to conduct a subsequent complaint inspection for the purpose of concluding for the aforementioned allegation. Upon arrival, LPA met with Leticia Rodriguez, Site Supervisor and we toured the facility. LPA observed proper care and supervision and ratio,
Based on records review and interviews were conducted all hired teachers and teacher assistance have the qualified units to work in the classroom with children except for S#20 does not have any ECE units LPA observed there is no immediately risk to children in care because record indicated S#20 has fingerprint cleared and associated to the above facility and was never left alone supervised children. During today's visit, facility representative disclosed S#20 has been removed from the facility on 11/15/2022. Therefore, based on the preponderance of evidence, the allegation of unqualifed staff caring for children in the classroom was substantiated. A finding means that the complaint is substantiated and the allegation is valid because the preponderance of the evidence standard has been met.
Facility was cited type B deficiencies. Please see Complaint Investigation Report LIC 9099D for deficiency cited. A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, Leticia Rodriguez.



Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
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 2
Control Number 54-CC-20221109154618
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: USC HEAD START
FACILITY NUMBER: 191870897
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/14/2022
Section Cited
CCR
101216.2(a)(d)
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Teacher aide Qualification
This requirement is not met as evidenced by based on record review facility failed to provide S#20 records of completion or enrolling in early childhood education or child development units. S320 is fingerprint cleared and associated to the facility
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Facility representative indicated S#20 has been removed on 11/15/2022 and no longer working for this facility. LPA did not observed S#20 during today's visit. LPA obtained a declaration statement. LPA to dissociate S#20 from the facility. POC cleared during today's visit.
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which 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: Trevino Cochran
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2