198016248-3-3-2022-33-CC-BVON-CCEQVW-20220311113058

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198016248
Report Date: 03/03/2022
Date Signed: 03/03/2022 10:13:58 AM

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
01/26/2022 and conducted by Evaluator Roxana Lopez

COMPLAINT CONTROL NUMBER: 33-CC-20220126102535

FACILITY NAME:	MARYVALE EARLY EDUCATION CENTER		FACILITY NUMBER:	198016248
ADMINISTRATOR:	STEPHANIE GARCIA		FACILITY TYPE:	850
ADDRESS:	2502 HUNTINGTON DR.		TELEPHONE:	(626) 357-1514
CITY:	DUARTE	STATE: CA	ZIP CODE:	91010
CAPACITY:	112	CENSUS: 71	DATE:	03/03/2022
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Stephanie Garcia - Director		TIME COMPLETED:	10:25 AM

ALLEGATION(S):

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Child sustained an injury while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst’s (LPA’s) Roxana Lopez and Steven Tung conducted a Complaint Investigation on 3/03/2022. Risk assessment was conducted upon entry and appropriate PPE was used. The purpose of this visit is to provide findings of the complaint investigation which was received on 1/26/2022. LPA’s met with Director Stephanie Garcia, to whom the purpose of the inspection was announced. A tour of the facility was given- census was taken.

Throughout the course of the investigation, interviews were conducted with reporting party, staff, children, and parents. LPA’s also reviewed and obtained copies of children’s rosters, personnel report, doctor notes, incident reports, declarations, and pictures.

Per initial complaint report, it was reported that child sustained an injury while in care.

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Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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-20220126102535

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: MARYVALE EARLY EDUCATION CENTER	FACILITY NUMBER: 198016248
	VISIT DATE: 03/03/2022

NARRATIVE

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The complainant alleges that they were called to pick up C1 since C1 had fallen hitting their chin on sink. Complainant took C1 to the doctor and it was determined that child needed glue to repair laceration.

LPA conducted interviews with Staff # 1-4 who corroborated that the entire class came inside from outside time. Staff # 3 was next to the sink as children were washing hands and Staff # 4 was setting up table activities. Per Staff # 3, C1 washed hands, walked away and then turned back to get a paper towel. As C1 turned around they tripped on their own feet causing them to fall forward and hitting chin on sink. Staff # 3 and # 4 corroborated that Staff # 3 witnessed the incident but was not able to prevent it. Staff # 3 helped C1 with first aid while the administrator was called. Once Staff # 1 arrived to the classroom C1 was helped with ice and parents were called to pick up child.

Parent interviews disclosed that they have no concerns with the facility. Children interviews resulted in no disclosures made about this specific allegation.

This agency has investigated the complaint child sustained an injury while in care. Based on LPA’s observations, interviews which were conducted and record reviews, the preponderance of the evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Although this incident did occur, it was an accident and was not due to negligence by the facility staff. First aid was applied immediately, and parent was notified timely. Therefore, there are no citations issued. Technical Advisory Note provided.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

LIC9099 (FAS) - (06/04)

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