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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494715
Report Date: 02/10/2022
Date Signed: 02/10/2022 07:53:29 PM

Unsubstantiated


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
11/05/2021 and conducted by Evaluator Dalicia Adkins
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20211105155806
FACILITY NAME:ABC SCHOOL HOUSEFACILITY NUMBER:
197494715
ADMINISTRATOR:BERNET-LEGUM, SUZANNEFACILITY TYPE:
850
ADDRESS:4102 W. VICTORY BLVDTELEPHONE:
(818) 842-8466
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY:58CENSUS: 31DATE:
02/10/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director, Ninelie RatavossianTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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9
Neglect/Lack of Supervision -Lack of supervision resulting in daycare child engaging in inappropriate activities
INVESTIGATION FINDINGS:
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On 2/10/2022 Licensing Program Analyst (LPA) Dalicia Adkins conducted an unannounced virtual tele-visit. LPA informed Director, Ninelie Ratavossian about the purpose of the visit, director guided LPA Adkins on a virtual tour of the facility. LPA Adkins observed 31 children and 6 teachers.

The purpose to today's visit is to conclude the above-mentioned allegation. During today's visit and unannounced visit on 11/10/21, LPA Adkins observed facility meeting Title 22 teacher-child ratio regulation, teachers were observed providing care and close supervising to children in care. Information obtained from records, interviews with staff and parents corroborate that teachers provide supervision for children in care. LPA interviewed staff and children, no disclosures were made about children engaging in inappropriate activities.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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 2
Control Number 30-CC-20211105155806
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: ABC SCHOOL HOUSE
FACILITY NUMBER: 197494715
VISIT DATE: 02/10/2022
NARRATIVE
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 LPA collected and reviewed the following records; Staff Timecards, Daily Sign In/Out Report, Written Unusual Incident/Injury Report, Children Files, Class Rosters (also used as checklist for transitioning), Copy of ABC House Staff Training Log, Parent Handbook and Classroom Schedules. Written statement collected and reviewed; details in written statement by teacher corroborated with information obtained during interviews.

Based on observations, interviews and record review it was determined that the above allegation to be UNSUBSTANTIATED, meaning that the allegation evidence was insufficient to satisfy the preponderance of the evidence standard.

No deficiencies sited during today's 2/10/2022 visit.

Exit interview conducted and copy of this report provided to License via email. If Licensee is unable to sign and scan, a reply to this email acknowledging receiving licensing reports may be used in lieu of signature
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2