191890351-12-8-2022-33-CC-BVON-CLXSBY-20221209124440

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191890351
Report Date: 12/08/2022
Date Signed: 12/08/2022 10:19:36 AM

Unsubstantiated

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 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
08/30/2022 and conducted by Evaluator Roxana Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20220830110711

FACILITY NAME:	GATES STREET EARLY EDUCATION CENTER		FACILITY NUMBER:	191890351
ADMINISTRATOR:	SCARLETT RAMIREZ-HOLGUIN		FACILITY TYPE:	850
ADDRESS:	2306 THOMAS STREET		TELEPHONE:	(323) 222-0277
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90031
CAPACITY:	114	CENSUS: 49	DATE:	12/08/2022
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Head Teacher Cindy Pulido		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Daycare child sustained a fracture due to lack of supervision

INVESTIGATION FINDINGS:

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An unannounced inspection was conducted by Licensing Program Analyst (LPA) Roxana Lopez on 12/8/2022. A risk assessment was conducted appropriate PPE was used. The purpose of this inspection is to provide the findings of the complaint investigation which was received on August 30, 2022. LPA met with Head Teacher Cindy Pulido to whom the purpose of the inspection was announced. Census was taken.

This investigation was conducted by Laura Garcia, Investigator with the Department’s Investigations Branch.

On September 6, 2022, Investigator Garcia conducted the initial complaint visit to the facility and conducted interviews with the Principal Holguin and staff present. Based on interviews conducted staff sought immediate medical attention for C1, taking them to school nurse. Staff followed nurse’s advice by applying ice and monitored C1 status while parents arrived to take C1 to the doctor.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

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 33-CC-20220830110711

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GATES STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191890351
	VISIT DATE: 12/08/2022

NARRATIVE

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On September 9, 2022, interviews were conducted with children and parents. On September 19, 2022, interviews were conducted with medical staff. Medical records were obtained.

Documents were obtained during investigation, including but not limited to; a current children’s roster, personnel roster and other pertinent documentation related to the above allegation.

This agency has investigated the complaint alleging Daycare child sustained a fracture due to lack of supervision. Based upon the evidence as presented above, the allegation has been determined to be Unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove alleged violation(s) did or did not occur, therefore at this time the above allegation is unsubstantiated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Head Teacher Cindy Pulido.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

LIC9099 (FAS) - (06/04)

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