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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197414787
Report Date: 12/21/2023
Date Signed: 12/21/2023 10:49:45 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, 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
10/19/2023 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20231019114801
FACILITY NAME:SHIRAYURI YOUCHIENFACILITY NUMBER:
197414787
ADMINISTRATOR:HIROKO KOZUCHIFACILITY TYPE:
850
ADDRESS:23325 SO. VERMONT AVENUETELEPHONE:
(310) 530-5830
CITY:TORRANCESTATE: CAZIP CODE:
90502
CAPACITY:79CENSUS: 20DATE:
12/21/2023
UNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:TIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff denied day care child a snack as a form of discipline
INVESTIGATION FINDINGS:
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On 12/21/2023 @ 9:30 AM, LPA Cohen conducted an unannounced visit for the purpose of delivering the finding against alleged complaint reported concerning the above preschool. Upon arrival, LPA Cohen observed six adults providing care for 20 children. LPA Cohen met with preschool director, Hiroko Kozuchi.

After conducting verbal interviews with staff members (written declarations obtained) and parents of children currently enrolled, and record reviews, the following conclusion has been reached: Unsubstantiated - A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

The investigation regarding the above allegation has been completed. No deficiencies will be issued.
An exit interview was conducted, and the above items discussed with preschool director. A copy of this report was provided to the director.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 30-CC-20231019114801
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SHIRAYURI YOUCHIEN
FACILITY NUMBER: 197414787
VISIT DATE: 12/21/2023
NARRATIVE
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On 10/25/2023 @ 1:00 PM, Licensing Program Analyst (LPA) Miriam Cohen conducted an unannounced complaint visit for the purpose of notifying the preschool director concerning the above-mentioned allegation and to perform an investigation. Upon arrival, LPA Cohen observed six adults providing care for 52 children. LPA Cohen met with preschool director, Hiroko Kozuchi, Director.
LPA acquired the following documentation:
*Children Roster
*Emergency ID with parent contact information
*Written declaration from staff members
LPA interviewed and obtained written declaration from staff members including preschool director; however, further witnesses and documentation will be needed to conclude the investigation. An exit interview was conducted with the above items discussed with preschool director. A copy of this report was provided.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2