Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198006098
Report Date: 09/15/2017
Date Signed: 09/15/2017 12:41:00 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/06/2017 and conducted by Evaluator Felicia Wyatt
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20170906152801
FACILITY NAME:RANCHO LOS AMIGOS CHILDREN'S CENTERFACILITY NUMBER:
198006098
ADMINISTRATOR:RAQUEL LUNAFACILITY TYPE:
850
ADDRESS:7755 GOLONDRINAS STREETTELEPHONE:
(562) 401-7981
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:59CENSUS: 51DATE:
09/15/2017
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Maria Luengas, Asst Director TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff operating out of ratio.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LPA Wyatt arrived at the facility for the purpose of addressing a complaint which alleges that the facility is operating out of ratio when staff are performing diaper changes. LPA met with Maria Luengas, Assistant Director and toured the preschool area. LPA recorded staff names and took a census of the children. LPA conducted interviews with members of staff and assistant director. Based on interviews conducted it was found that on Friday, September 1, 2017 the preschool class was out of ratio when teacher #1 left the classroom to take a child to the restroom leaving teacher# 2 alone to supervise 17 children. Based on interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22 101216.3(a) Teacher-Child Ratio, is being cited on the attached LIC 9099D.

REPORT CONTINUES ON THE NEXT PAGE
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Felicia WyattTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2017
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 5
Control Number 33-CC-20170906152801
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: RANCHO LOS AMIGOS CHILDREN'S CENTER
FACILITY NUMBER: 198006098
VISIT DATE: 09/15/2017
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
LPA issued the Confidential Names List (LIC 811) to Maria Luengas, Assistant director during this visit. The Confidential Names List documents the staff involved with the incidents documented in this report.

Upon receipt of this report documenting a substantiated complaint allegation and a Type A deficiency, the Licensee shall do the following:

1. Post the Notice of Site visit and any licensing report documenting a type “A” deficiency.
2. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.
3. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return and a copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year).
4. The Acknowledgement form (LIC 9224) must be signed and maintained in each child’s file immediately upon receipt from parent. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this visit.

Exit interview was conducted with Maria Luengas, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Felicia WyattTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 33-CC-20170906152801
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RANCHO LOS AMIGOS CHILDREN'S CENTER
FACILITY NUMBER: 198006098
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2017
Section Cited
CCR
101216.3(a)
1
2
3
4
5
6
7
Teacher – Child Ratio
There shall be a ratio of one teacher supervising no more than 12 children in attendance except as specified in (b) and (c).
1
2
3
4
5
6
7
Assistant Director agrees to submit a written plan of correction to LPA detailing plan to avoid being out of ratio when teachers perform diaper changes or children are taken to the restroom.
8
9
10
11
12
13
14
On 9/1/17 teacher #1 left the class to take a child to the bathroom which then left teacher #2 alone to supervise 17 children.
8
9
10
11
12
13
14
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.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Felicia WyattTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2017
LIC9099 (FAS) - (06/04)
Page: 3 of 5