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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197417593
Report Date: 07/19/2023
Date Signed: 07/19/2023 01:47:45 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/24/2023 and conducted by Evaluator Justeene Tamayo
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230524152648
FACILITY NAME:A PLACE OF OUR OWN LEARNING ACADEMY,INCFACILITY NUMBER:
197417593
ADMINISTRATOR:ADAMS, ALLEAFACILITY TYPE:
850
ADDRESS:2739 W. AVENUE LTELEPHONE:
(661) 718-3614
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:77CENSUS: 28DATE:
07/19/2023
UNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Adrienne Tolliver, Director TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Allegation

-Facility playground is unsanitary.
INVESTIGATION FINDINGS:
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On 07/19/2023, Licensing Program Analyst (LPA) Justeene Tamayo met with Director Adrienne Tolliver for the purpose of concluding the investigation concerning the above complaint allegation. LPA toured the facility and observed 28 preschool children in care, along with 4 teachers.

During walk through of the outdoor playground area, LPA observed cat feces in the facility preschool playground sand, which poses a potential risk to children in care.

Based on the information obtained, the above allegation is deemed Substantiated. A finding of substantiated means that allegation is valid. Facility has been cited a Type B citation Outdoor Activity Space 101238.2(d)(2). Please see LIC-9099D for more information.

An exit interview was conducted, and a copy of this report was read and provided to the Director on this date, along with a copy of her appeal rights and Notice of Site Visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023
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 12-CC-20230524152648
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC
FACILITY NUMBER: 197417593
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2023
Section Cited
CCR
101238.2(d)(2)
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Outdoor Acitivity Space 101238.2(d)(2): The surface of the outdoor activity space shall be maintained: Free of hazards including, but not limited to, holes, broken glass and other debris..
This requirement was not met as evidence by:
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LPA obtained a contract copy from Rubbitall.com of sand box being replaced with rubber surfacing and turf. Per Director, the contruction will be started August 2023. At this time, no preschool children have been outside.
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LPA observed cat feces in the preschool playground sand, which poses a potential risk to children in care. Facility has been cited a Type B Citation.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023
LIC9099 (FAS) - (06/04)
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