191890351-5-11-2023-33-CC-BVON-CS7VAX-20230526161639

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191890351
Report Date: 05/11/2023
Date Signed: 05/11/2023 02:02:44 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 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
04/13/2023 and conducted by Evaluator Mireya Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20230413165753

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: 54	DATE:	05/11/2023
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Principal, Scarlett Ramirez-Holguin		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Child sustained a fracture while in care due to inadequate supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mireya García arrived unannounced at the facility for the purpose of conducting a follow up complaint investigation to deliver findings regarding the allegation listed above. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with Scarlett Ramirez-Holguin, Principal who guided LPA on a tour of the facility. There were fifty-four (54) children observed to be present at the facility during LPA’s arrival.

Information provided by the complainant alleges that child sustained a fracture while in care due to inadequate supervision. During this investigation LPA M. García obtained a copy of Children’s roster dated 04/18/23, sign in and sign out sheets for classrooms #2 and #3 for the week of 04/10/23-04/14/23, the notice of first aid completed for child #1 dated 04/11/23, child #1’s physical education restriction notice from physician dated 05/01/2023, staff written statements on LIC 855 Declarations were obtained from Staff #1-4, and interviews were conducted with child #1, three (3) day care staff and Principal.
Report continues on next page 1 of 3.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

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 33-CC-20230413165753

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GATES STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191890351
	VISIT DATE: 05/11/2023

NARRATIVE

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Based on observations made on 04/18/23 & 05/11/23, LPA Garcia did not observe any tripping hazards near or on the area where incident took place. In addition, LPA Garcia inspected tricycles and no hazards were visibly observed on any of the tricycles.

In records review of the Notice of First Aid notice dated 04/11/2023, first aid was noted that child #1 tripped with the bicycle while playing outside. Ice was applied on child’s left arm (inside elbow), form was completed by Staff #2 and signed by child #1’s parent on 04/11/23.

In records review of the sign in and sign out sheets for classrooms #2 & #3, LPA Garcia determined that at the time of incident there were three (3) staff who were present outdoors providing care and supervision to fifteen(15) children. Therefore, teacher-child ratio is met.

Based on information obtained during interviews conducted with staff, witness, and the child #1, LPA Garcia determined that during outdoor play child#1 was on a tricycle, and while getting off tricycle child #1 tripped on the tricycle wheel with child’s left foot causing child to fall to the floor and landed on right side of the body. Although staff was present and Staff #1 observed the incident, staff could not reach the child in time to prevent child from falling. Interview with child #1 confirms falling from tricycle on the floor and Staff #1 was present and observe child #1 fall. Child #1 has returned to day care. Based on the interviews conducted, at this time there is not enough evidence to support the above allegation.

Report continues on next page 2 of 3.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20230413165753

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GATES STREET EARLY EDUCATION CENTER	FACILITY NUMBER: 191890351
	VISIT DATE: 05/11/2023

NARRATIVE

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This agency has investigated the complaint alleging child sustained a fracture while in care due to inadequate supervision. 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, based on interviews conducted and records review; Staff #1 witness incident, the facility followed all proper procedures; Staff administered first aid, child’s parent was notified, notice of first aid was given and signed by parent, incident report was sent in properly and timely and first aid was administered to child. Therefore, at this time the above allegation is deemed unsubstantiated.

Should additional information become available in the future, this investigation may be reopened.

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

Exit interview conducted and report was reviewed with facility representative, Scarlett Ramirez-Holguin.

Report ends here page 3 of 3.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Mireya Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

LIC9099 (FAS) - (06/04)

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