197419522-7-19-2023-58-CC-BBEL-CTX5RN-20230720201124

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197419522
Report Date: 07/19/2023
Date Signed: 07/19/2023 02:05:26 PM

Substantiated

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
04/20/2023 and conducted by Evaluator Antonio Almanza

PUBLIC

COMPLAINT CONTROL NUMBER: 58-CC-20230420165243

FACILITY NAME:	CREATIVE HANDS LEARNING ACADEMY		FACILITY NUMBER:	197419522
ADMINISTRATOR:	MADISON, NATASHA LORENE		FACILITY TYPE:	850
ADDRESS:	2320 W. MARTIN LUTHER KING		TELEPHONE:	(310) 462-6097
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90008
CAPACITY:	63	CENSUS: 60	DATE:	07/19/2023
		UNANNOUNCED	TIME BEGAN:	01:24 PM
MET WITH:	Director/Owner Natasha Madison		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained an unexplained injury while in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 07/19/23 at 2:28 PM, Licensing Program Analyst (LPA) Antonio Almanza conducted an unannounced site visit for the purpose of delivering findings for complaint allegations received on 04/20/23, associated to complaint control number 58-CC-20230420165243. LPA met with Director/Owner Natasha Madison and explained the purpose of the visit. During today’s visit, there were 7 staff providing care and supervision to 51 children in care.

During the course of the investigation, LPA Almanza conducted interviews with four staff and obtained photographs of the injuries to child 1’s (C1) face.

The parent of C1 disclosed that on 04/13/23 at 7:00 AM, C1 was dropped off at the Child Care Center without any injuries. The parent picked up C1 at 3:40 PM and C1’s right eye was bruised and purple. The parent noticed the bruised eye and questioned the Director (S4) about the injury. S4 was not aware of the injury and could not provide an explanation.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
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)

Page: 1 of 3

Control Number 58-CC-20230420165243

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CREATIVE HANDS LEARNING ACADEMY	FACILITY NUMBER: 197419522
	VISIT DATE: 07/19/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

S4 disclosed that on C1’s last day of attendance, during pick up, S4 asked C1 what happened to C1’s head, and C1 told parents that C1 ran into the door. S4 noticed a bump on the right side of C1’s forehead but does not recall C1 having a black eye. S4 disclosed that does not know when the child sustained the injuries and on the day of the injury it was a busy day. S4 disclosed that C1’s teacher (S5) was present during pick up and did not know when the injuries happened.

LPA Almanza received photographs of the injuries to the child's face. The child's right eye is bruised and there is a bump on the right eyebrow.

After considering the information provided during the interviews and photographs of the injuries, it has been determined that the facility staff were unaware of the injuries sustained by C1 while at the child care center.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC9099D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Natasha Madison.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
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

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 58-CC-20230420165243

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CREATIVE HANDS LEARNING ACADEMY	FACILITY NUMBER: 197419522
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/19/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/24/2023 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	101229(a), Responsibility for Providing Care and Supervision, The licensee shall provide care and supervision as necessary to meet the children's needs. This Requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director agrees to provide staff with memo regarding wellness checks being performed in the morning, mid-day, and before going home in order to determine any injuries children may have sustained that they are not aware of.
	8 9 10 11 12 13 14	Based on observation, interview and record review, facility staff were unaware of the injuries sustained by C1 while in care, which poses a potential Health or Safety, or personal rights risk to persons in care.	8 9 10 11 12 13 14	Director will provide copy of memo with staff signatures indicating that they have received memo.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
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)

Page: 3 of 3