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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494575
Report Date: 05/11/2022
Date Signed: 05/11/2022 12:10:53 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, 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
03/24/2022 and conducted by Evaluator Denise Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220324145344
FACILITY NAME:DEVONSHIRE INFANT CENTERFACILITY NUMBER:
197494575
ADMINISTRATOR:MERADITH GRABLEFACILITY TYPE:
830
ADDRESS:21203 DEVONSHIRE STREETTELEPHONE:
(818) 700-2821
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:46CENSUS: 18DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Amalia Gutierrez, Director Assistant TIME COMPLETED:
10:25 AM
ALLEGATION(S):
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9
Staff to child ratio
INVESTIGATION FINDINGS:
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On 05/11/2022 at 8:25AM, Licensing Program Analyst (LPA) Denise Miranda conducted a visit at Devonshire Infant Center, for the purpose of delivering the investigation finding for the above-mentioned allegations. Upon arrival, LPA Miranda met with Amalia Gutierrez, Director Assistant and informed the purpose of the visit. At 8:28am, There are 18 infants total with 4 Staff and Director Assistant present at the facility.
During this inspection, LPA reviewed the sign in&out and staff timesheet for the days 05/10/2022 and 5/11/2022, conducted interviews and observed the following: On 5/11/2022: classroom#3 have one teacher(#1) supervising 7 infants, classroom #2 from 7:14am to 8:19am one teacher(#2) for 6 infants. LPA observed Facility was over ratio during this inspection visit.
On the sign in & out and staff timesheet for the day 5/10/2202 LPA observed that from: 6:57am the time that the first infant arrived to 8:00am, one Teacher (#5) had 12 infants in
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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 4
Control Number 30-CC-20220324145344
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: DEVONSHIRE INFANT CENTER
FACILITY NUMBER: 197494575
VISIT DATE: 05/11/2022
NARRATIVE
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care. Per Teacher#5 the second teacher (#6) arrived 7:15am, however from 6:57am to 8:00am the facility has 12 infants present with two teacher present supervising 12 infants and doing the drop off at the gate area, that does not have visual access to the classrooms.
Around 8:35am LPA observed that during this complaint inspection, one child was removed from classroom room#2 (that was 9 infants) and moved to classroom #1.

Based on the observations gathered throughout the course of the investigation which include LPA interviews and review documentation, the allegation above is substantiated, means that the allegations are valid because the preponderance of the evidences standard has been met. Licensee was cited Type A deficiency, according to California Code of Regulations Title 22 (see LIC 809D report for deficiencies).

A copy of this report must be copied and given to all parents and to the parents of any child enrolling within the next 12 months.

LPA provided a copy of the form LIC 9224 Acknowledgement of receipt of licensing Report. Exit interview was conducted with Director, /including, but not limited to Provider Appeal Rights, and copy of notice of visit.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
03/24/2022 and conducted by Evaluator Denise Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220324145344

FACILITY NAME:DEVONSHIRE INFANT CENTERFACILITY NUMBER:
197494575
ADMINISTRATOR:MERADITH GRABLEFACILITY TYPE:
830
ADDRESS:21203 DEVONSHIRE STREETTELEPHONE:
(818) 700-2821
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:46CENSUS: 18DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Amalia Gutierrez, Director Assistant TIME COMPLETED:
10:25 AM
ALLEGATION(S):
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9
Staff do not properly supervise daycare children
INVESTIGATION FINDINGS:
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On 05/11/2022 at 8:25AM, Licensing Program Analyst (LPA) Denise Miranda conducted a visit at Devonshire Infant Center, for the purpose of delivering the investigation finding for the above-mentioned allegation. Upon arrival, LPA Miranda met with Amalia Gutierrez, Director Assistant and informed the purpose of the visit. There are 18 infants with 4 Staff present at the facility.
Based on the information gathered throughout the course of the investigation which include LPA observation and interviews, the allegation above is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidences to prove that the alleged violation occurred.
An exit interview was conducted, and a copy of this report was provided to Amalia Gutierrez, Director Assistant.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 30-CC-20220324145344
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: DEVONSHIRE INFANT CENTER
FACILITY NUMBER: 197494575
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/11/2022
Section Cited
CCR
101416.5(b)
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101416.5 Staff-Infant Ratio: (b) There shall be a ratio of one teacher for every four infants in attendance. This standard was not met based on evidence obtained through the interviews, revirew documents observations. On 5/11/22 LPA reviewed sign


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Per Director Assistant, teachers will be schedule to start ealry and temporary agency will be contact for hire teachers. Director assistant provided a declaration regarding her plan of correction how to maintain the staff-infant ratio. .
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sign in & out and timesheets for the days 5/10 and 5/11/22 and observations. Faciltiy was over ratio, one teacher was supervisint more than 4 infants. This poses an immediate Health and Safety risk to children in care.
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Per Director, she understand that regulation Staff-Infant Ratio, that shall be a ratio of one teacher for every four infants in attendance. LPA provided copy of title22 101416/5 Staff infant ratio.
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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: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4