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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198014885
Report Date: 09/13/2023
Date Signed: 09/13/2023 05:29:14 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/15/2023 and conducted by Evaluator Franchesca White
COMPLAINT CONTROL NUMBER: 54-CC-20230815113410
FACILITY NAME:UNIQUE'S PRESCHOOLFACILITY NUMBER:
198014885
ADMINISTRATOR:LETICHA TONEYFACILITY TYPE:
850
ADDRESS:9322 S. MAIN STREETTELEPHONE:
(323) 779-2595
CITY:LOS ANGELESSTATE: CAZIP CODE:
90003
CAPACITY:25CENSUS: DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
03:19 PM
MET WITH:Johnnie JohnsonTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Supervision - Unsupervised Child
Medication - Staff Administering medicine without consent of parent
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Franchesca White conducted an unannounced visit for the purpose of delivering findings for complaint received to the department 8/15/2023. LPA White was greeted by Johnnie Johnson, announced purpose of visit and was granted entry to the facility.

The allegation of supervision is substantiated due to the preponderance of evidence based on LPAs’ observation during subsequent inspection on 6/29/2023, and interviews with S1 and S2. C1 opened the door and left the classroom while the teacher had children in the restroom. LPA informed teacher that child was on the playground unsupervised. RP and S2 provided details to C1 being left indoors to sleep while staff and children played outside. C1 woke up and ran to S2 classroom. Outdoor staff was notified, and S3 came and got C1.
Report Continued 1 of 2 Pages
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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 54-CC-20230815113410
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: UNIQUE'S PRESCHOOL
FACILITY NUMBER: 198014885
VISIT DATE: 09/13/2023
NARRATIVE
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The allegation of medication being administered by staff without the consent of parent is substantiated due to the preponderance of evidence based on interviews and record review. S1 and S2 witnessed Ms. Johnnie Johnson give melatonin gummy to C1. During interviews, LPA White obtained statements confirming, per licensee she states she does not administer medication to the children.

Facility will be cited Type A violations for substantiated allegations. Please see Complaint Investigation Report LIC 9099D for deficiencies cited.

Informal Meeting date will be determined by Monterey Park Southwest Regional Office.

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. 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). Acknowledgement of Receipt (LIC 9224 form) must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview conducted and report was reviewed with the Director, Leticha Toney during which appeal rights were given and explained. A copy of the Appeal Rights was provided. The Licensee’s signature on this report acknowledges receipt of rights.

Report Ends 2 of 2 Pages
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 54-CC-20230815113410
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: UNIQUE'S PRESCHOOL
FACILITY NUMBER: 198014885
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
09/29/2023
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide...supervision as necessary...(1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation.
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This requirement is not met as evidenced by based on observation and interviews Licensee did not provide supervision for child in care which posed a potential health and safety risk to persons in care.
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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: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 54-CC-20230815113410
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: UNIQUE'S PRESCHOOL
FACILITY NUMBER: 198014885
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/01/2023
Section Cited
CCR
101226(e)(4)(b)
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For each nonprescription medication, the licensee shall obtain, in writing, approval and instructions from the child's authorized representative for the administration of the medication to the child.
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Licensee states she will provide copies of old and revised enrollment packet with proof of change to medication procedures by or before POC date
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This requirement is not met as evidenced by licensee not having parental consent to administer medication to child in care which posed an immediate health and safety risk to children in care.
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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: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4