191871812-9-1-2021-54-CC-VCOK-C6WW2P-20210916165441

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191871812
Report Date: 09/01/2021
Date Signed: 09/01/2021 01:27:16 PM

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
06/17/2021 and conducted by Evaluator Jeanette Estrada

COMPLAINT CONTROL NUMBER: 54-CC-20210617091824

FACILITY NAME:	CHILDTIME CHILDREN'S CENTER		FACILITY NUMBER:	191871812
ADMINISTRATOR:	ANA FRAGOSO-TOVALIN		FACILITY TYPE:	850
ADDRESS:	4820 S. EASTERN AVENUE #F		TELEPHONE:	(323) 721-0552
CITY:	COMMERCE	STATE: CA	ZIP CODE:	90040
CAPACITY:	72	CENSUS: 33	DATE:	09/01/2021
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Director Ana Fragoso -Tovalin		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Day care child sustained injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced complaint inspection for the purpose of delivering findings. Initial complaint investigation was conducted on 06/24/21.
LPA met with Director, Ana Fragoso-Tovalin and explained reason for the visit. Director gave LPA a tour of the facility. There were 33 children and 4 staff present.
During the course of the investigation, LPA reviewed pertinent documents and conducted interviews. The investigation revealed that although Child 1 attended the facility from June 14, 2021 to June 15, 2021, Child 1 was not observed by to have been injured while in care. LPA reviewed the LIC 702 Child’s Pre-Admission Health History-Parent’s Report form dated 05/09/21(reviewed on 6/24/21), messages dated 6/14/21 on Brightwheel, the app used for parent communication (reviewed on 6/23/21) and the Enrollment Registration Information form dated 5/12/21 (reviewed 8/17/21) which informed the facility that at times, Child 1 hits themselves or hits their head on the wall or on the floor when they become frustrated.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

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 54-CC-20210617091824

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: CHILDTIME CHILDREN'S CENTER	FACILITY NUMBER: 191871812
	VISIT DATE: 09/01/2021

NARRATIVE

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Per interviews conducted with Staff, Child 1 was observed to have a red mark on their forehead on the first day the child was present. Per Staff 1, Child 1 was also observed to have expressed their frustration as described on the forms and on the messages on Brightwheel but Staff 1 intervened. Per Staff 1, Child 1 almost hit their head on a wall, but she was able to put her hand in front before Child 1 hit the wall. Child 1 was not noted to have injuries.

Based on the information obtained throughout the investigation, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted with Director, Ana Tovalin A copy of the appeal rights (LIC9058 01/16) were provided and explained. Upon receipt, Director posted the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

LIC9099 (FAS) - (06/04)

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