Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198006099
Report Date: 11/20/2018
Date Signed: 11/20/2018 02:39:47 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
09/05/2018 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20180905170259
FACILITY NAME:RANCHO LOS AMIGOS CHILDREN'S CENTERFACILITY NUMBER:
198006099
ADMINISTRATOR:MARIA LUENGASFACILITY TYPE:
830
ADDRESS:7755 GOLONDRINAS STREETTELEPHONE:
(562) 401-7981
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:35CENSUS: 19DATE:
11/20/2018
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Ana MartinezTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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9
Personal Rights- Staff grab child's arm and threw him down resulting in him hitting head
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection for the purpose of delivering the finding of the above allegation. LPA met with Director Ana Martinez who guided this LPA on a tour of the facility. There was a total of 19 children present during today's inspection.

During the course of the investigation LPA Navarro conducted interviews with the Complainant, Director, and Staff. Complainant stated that from the corner of their eye they observed Staff # 4 grab a child and threw them on the floor. Director did not witnessed the incident. Per Director, Staff #3 stated that child threw himself back resulting in child hitting his head on a pole. LPA Navarro interviewed Staff #4 who denied the allegation and stated they did not throw the child down. Staff #4 stated as they reached to grab child to prevent them from falling back, child threw themselves back and hit his head on a pole. Staff #2 and Staff #3 did not observe the incident. Staff #1 did state that she heard about the incident by the complainant but did not witness the incident.
*Report continues on the next page*
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2018
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 33-CC-20180905170259
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: 198006099
VISIT DATE: 11/20/2018
NARRATIVE
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Due to a conflict of information received from all parties involved, LPA is unable to determine if the allegations did or did not occur. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegations are Unsubstantiated.

Exit interview was conducted with Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2018
LIC9099 (FAS) - (06/04)
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