198011059-5-8-2024-33-CC-CGAN-D64VYP-20240610165128

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198011059
Report Date: 05/08/2024
Date Signed: 05/08/2024 12:20:03 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, 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
04/30/2024 and conducted by Evaluator Anomeh Eivazian

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20240430163233

FACILITY NAME:	BONNIE ACADEMY		FACILITY NUMBER:	198011059
ADMINISTRATOR:	HASMIK KUPELIAN		FACILITY TYPE:	850
ADDRESS:	534 W. GLENOAKS BLVD.		TELEPHONE:	(818) 244-3241
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91202
CAPACITY:	66	CENSUS: 56	DATE:	05/08/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Hasmik Kupelian, Director		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff did not provide adequate supervision to children resulting in day care child being bitten several times

INVESTIGATION FINDINGS:

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At 8:30 AM, Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection in regards to the above allegation. LPA met with Hasmik Kupelian, Director who guided analyst on a tour of the facility. During this inspection there were total of 50 children present in the facility.

During this investigation LPA conducted interviews with three staff and complainant. LPA obtained director notes regarding this complaint allegation, a letter from child#1 physical therapy, email communication between school and child#2 parent, a copy of facility accident report for child#2 dated 02/14/24, and facility sign in/out for 02/14/24.

Facility reported an unusual incident report to the licensing department on 02/14/24.

REPORT CONTINUES ON NEXT PAGE 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

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 3

Control Number 33-CC-20240430163233

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: BONNIE ACADEMY	FACILITY NUMBER: 198011059
	VISIT DATE: 05/08/2024

NARRATIVE

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Based on three staff interviews, on 02/14/24 while children were passing out Valentine's goodies to each other, all the children were sitting in a circle around the table, child# 1 and child#2 were sitting next to each other, staff did not observe when child#1 bit child#2 as far as child #2 did not cry at that time. Once staff cleaned the tables, staff#1, staff#2 and staff#3 noticed child#2 was crying while was on the colorful couch in the classroom, and observed child#1 was bitting child#2. Once staff#3 reached out to child#1, staff noticed three bite marks was already on child#2's right arm and stopped child#1.
Per three staff interviews they did not observe when child#1 bit child#2 while they were sitting on the table.

Based on pictures that was provided by complainant, child#2 had multiple bite marks on both hands.

Based on LPA observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been meet, therefore the above allegation is found to be Substantiated at this time. Title 22 Regulation code 101229 (a)-Responsibility for Providing Care and Supervision: The licensee shall provide care and supervision as necessary to meet the children's needs is being cited on the attached LIC 9099D.

LPA Eivazian informed director, Hasmik Kupelian that this report dated 05/08/24 document(s) 1Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Anomeh Eivazian informed the director, Hasmik Kupelian to provide a copy of this licensing report dated 05/08/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Hasmik Kupelian, director.

REPORT END 2 of 2

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20240430163233

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: BONNIE ACADEMY	FACILITY NUMBER: 198011059
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/08/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/09/2024 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision The licensee shall provide care and supervision as necessary to meet the children's needs This requirement was not met as evidenced by...	1 2 3 4 5 6 7	Per director, child#1 is under close supervision after this incident, also staff will ensure all the children will be under supervision all the time. A written statement will be submitted to LPA by plan of correction due date.
	8 9 10 11 12 13 14	Based on three staff interviews, on 02/14/24 child#1 bit child#2 and staff did not observe when child#1 bit child#2 and left multiple bite marks on child#2 both hands. This poses immediate health, safety and personal right risk to the children in care.	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.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

LIC9099 (FAS) - (06/04)

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