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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197414572
Report Date: 02/13/2023
Date Signed: 02/13/2023 10:53:01 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
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 Doris Whitmore
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20221109102630
FACILITY NAME:KIDSVILLE U.S.A.FACILITY NUMBER:
197414572
ADMINISTRATOR:PERERA, MAUREENFACILITY TYPE:
850
ADDRESS:8472 CORBIN AVENUETELEPHONE:
(818) 886-3508
CITY:NORTHRIDGESTATE: ZIP CODE:
91324
CAPACITY:72CENSUS: 34DATE:
02/13/2023
UNANNOUNCEDTIME BEGAN:
09:13 AM
MET WITH:Maureen PereraTIME COMPLETED:
10:40 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation: Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 On 02/13/2023 at 9:13 a.m,Licensing Program Analyst ( LPA) Doris Whitmore conducted an unaanounced complaint visit for the purpose of delivering the findings of the investigation regarding the allegation above. LPA met with Maureen Perera Director and observed 34 children and 4 staff at the time of the visit.
On 11/14/2022, LPA Whitmore initiated the complaint investigationm and met with Director Maureen Perera. LPA toured the facility indoors and outdoors, observing proper teacher/ child ratios with 27 children and 4 staff. LPA obtained copies of the facility roster,& current staff roster.Investigation Burearu(IB) conducted a full investigation, which included staff interviews and interviews with relevant parties, as well a record review, including a review of documentation as related to the allegation. With the information obtained and interviews conducted the investigation did not provide sufficient evidence to substantiate the allegation of personal rights. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation 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 deemed unsubstantiated. There were no deficiencicies cited An exit interview was conducted, and a copy of this report, appeal rights, along with Notice of Site Visit was provided to Maureen Perera Director
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023
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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