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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197492945
Report Date: 11/24/2021
Date Signed: 11/24/2021 02:24:02 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
09/29/2021 and conducted by Evaluator Brigitte Tsutaoka
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20210929134051
FACILITY NAME:KIDS TOWN CHILDCARE CENTER, LLCFACILITY NUMBER:
197492945
ADMINISTRATOR:ANA GARCIAFACILITY TYPE:
840
ADDRESS:1825 WEST AVENUE J, SUITE 125TELEPHONE:
(661) 951-2070
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:45CENSUS: 11DATE:
11/24/2021
UNANNOUNCEDTIME BEGAN:
09:28 AM
MET WITH:Jessica DonisTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Allegation 2: Toxic Chemicals are accessible to children in care.
INVESTIGATION FINDINGS:
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On November 24, 2021 at 9:38AM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection to deliver findings on the above allegation. LPA disclosed the purpose of inspection and was granted entry by Assistant Director Jessica Donis. Upon entry, LPA observed 11 children in care.

During the course of the investigation, LPA interviewed staff and children. Staff disclosed an incident involving Child 1 who was able to get ahold of a bleach cleaning solution which was left out in the preschool room, causing him to spray staff and children. LPA also observed two cleaning solutions left on the counter in the preschool room.
Children interviewed disclosed they are not permitted to play with the cleaning solutions, but are permitted to assist in cleaning up after themselves utlizing "wipies" and towels.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Brigitte Tsutaoka
LICENSING EVALUATOR SIGNATURE:

DATE: 11/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2021
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 12-CC-20210929134051
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: KIDS TOWN CHILDCARE CENTER, LLC
FACILITY NUMBER: 197492945
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/25/2021
Section Cited
CCR
101238(g)
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101238 Building and Grounds (g)disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidence by:
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Director agreed to submit a plan to the Department identifying how to prevent child acces to cleaning chemicals and a completed staff training sign-in sheet on proper chemical storage no later than 11/25/2021.
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Based on observation and interview, facility staff failed to place the cleaning bleach solution back in the locked cabinet, enabling Child 1 to gain access to the cleaning chemical, which poses an immediate Health and Safety risk to children in care.
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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: Carissa Bell
LICENSING EVALUATOR NAME: Brigitte Tsutaoka
LICENSING EVALUATOR SIGNATURE:

DATE: 11/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20210929134051
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: KIDS TOWN CHILDCARE CENTER, LLC
FACILITY NUMBER: 197492945
VISIT DATE: 11/24/2021
NARRATIVE
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Based on evidence obtained and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found Substantiated. California Code of Regulations, Title 22, Division 12 Chapter 1 101238 Buildings and Grounds Type A violation is being cited during this inspection. See LIC9099D for deficiency details

Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent. A copy of the Acknowledgment of receipt of licensing report (LIC9224) was
provided and must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

An exit interview was conducted, a copy of this Report, Appeal Rights, and Notice of Site Visit was provided to Assistant Director.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Brigitte Tsutaoka
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3