197494551-1-15-2025-58-CC-RRAS-DD23DH-20250117170931

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197494551
Report Date: 12/12/2024
Date Signed: 01/15/2025 11:07:24 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
09/17/2024 and conducted by Evaluator Elicia Calvillo

COMPLAINT CONTROL NUMBER: 58-CC-20240917145023

FACILITY NAME:	OUR LADY GRACE PRESCHOOL		FACILITY NUMBER:	197494551
ADMINISTRATOR:	THOMAS AMBRIZ		FACILITY TYPE:	850
ADDRESS:	17720 VENTURA BLVD		TELEPHONE:	(818) 344-4126
CITY:	ENCINO	STATE: CA	ZIP CODE:	91316
CAPACITY:	15	CENSUS:	DATE:	12/12/2024
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:			TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Staff do not provide adequate supervision to day care children while using the restroom

INVESTIGATION FINDINGS:

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***THIS IS AN AMENDED REPORT WHICH SUPERSEDES THE PREVIOUS REPORT***
On 12/12/2024 at 08:15 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted a complaint visit to deliver findings on the above allegation. LPA identified self and met with Thomas Ambriz, Principal who allowed entry into the facility and provided LPA a guided tour of the inside and outside of the facility. Upon arrival there were 9 children and 2 staff.

During today’s visit, LPA addressed the allegations that Staff do not provide adequate supervision to day care children while using the restroom. Throughout the course of the investigation, LPA obtained the LIC 9040 Child Care Facility Roster, interviewed Principal, interviewed parents, interviewed children, and interviewed staff.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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 58-CC-20240917145023

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: OUR LADY GRACE PRESCHOOL	FACILITY NUMBER: 197494551
	VISIT DATE: 12/12/2024

NARRATIVE

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Information provided by the Reporting Party (RP) indicates that staff do not provide adequate supervision to day care children while using the restroom.

When interviewing Thomas Ambriz, Principal it was disclosed that during the repairs, arrangements were made for the Preschool children to use an alternate restroom, children were escorted to and from the restroom by staff, and supervised by staff when using the alternative restroom.

When interviewing staff, staff disclosed that the Preschool restroom needed repairs, children used an alternative restroom, staff escorted children to and from the restroom and staff supervised the children at all times.

When interviewing parents, parents disclosed that the Preschool restroom was not working, their children used the “big kids potty”, and that their teachers went to the restroom with them.

When interviewing children, children disclosed that the restroom in the classroom was broken, they used the “big kids potty”, and their teachers went to the big kids restroom with them.

Based on LPA’s observations and interviews which were conducted and record review, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Janet Eisenreich, Preschool Teacher including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC9099 (FAS) - (06/04)

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