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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197411901
Report Date: 06/12/2023
Date Signed: 06/12/2023 03:22:53 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 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
06/02/2023 and conducted by Evaluator Denise Gibbs
COMPLAINT CONTROL NUMBER: 54-CC-20230602112914
FACILITY NAME:MAPLE PRIMARY CENTER STATE PRESCHOOLFACILITY NUMBER:
197411901
ADMINISTRATOR:SHARYN CLARKFACILITY TYPE:
850
ADDRESS:3601 S. MAPLE AVE. RM. 100 105TELEPHONE:
(323) 232-0984
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:48CENSUS: 0DATE:
06/12/2023
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Sharyn Clark, PrincipalTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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On June 12, 2023, at 10:45 a.m., Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced follow-up complaint inspection and met with Principal, Sharyn Clark. LPA disclosed the purpose of the inspection and was granted entry into the facility.

There were no children present at the facility today due to summer vacation. LPA conducted in person interviews with staff and phone interviews with additional parties to gain information regarding the complaint.

Information obtained provided no disclosures regarding the allegation. Per staff, positive behavior support and verbal redirection is used when children do not follow the rules at school. Staff only physically redirect children by holding their hand if they are going to hurt themselves or others. This facility has a Preschool Collaborative Program (PCC), with children that have Individual Behavior Plans (IEP)

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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
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 54-CC-20230602112914
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MAPLE PRIMARY CENTER STATE PRESCHOOL
FACILITY NUMBER: 197411901
VISIT DATE: 06/12/2023
NARRATIVE
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where alternate forms of behavior support is documented. The PCC teacher is trained on alterative behavior supports for these children. Children interviewed did not provide information regarding staff grabbing, pinching, or scratching them at anytime. Photos of child's injuries were not provided. Additional parties interviewed had no concerns with the safety or discipline at the facility, therefore the allegation is unsubstantiated. If any additional information is provided at a later date, this allegation will be reviewed.

No deficiencies will be cited today 6/12/23.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Principal, Sharyn Clark. A copy of this report and appeal rights were provided.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2