198016425-12-7-2023-33-CC-CGAN-D2MRJL-20240220120408

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198016425
Report Date: 12/07/2023
Date Signed: 12/07/2023 04:19:03 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 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
12/04/2023 and conducted by Evaluator Cynthia Reyes

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20231204091531

FACILITY NAME:	KIDDIE ACADEMY OF GLENDORA		FACILITY NUMBER:	198016425
ADMINISTRATOR:	BETH HOLMES		FACILITY TYPE:	830
ADDRESS:	1339 SOUTH GRAND AVENUE		TELEPHONE:	(626) 691-0242
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY:	24	CENSUS: 12	DATE:	12/07/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Heather Jenkins, Site Supervisor		TIME COMPLETED:	04:25 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Admission Agreement/Reporting Requirements

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analysts (LPA) Cynthia Reyes conducted an unannounced site inspection to investigate the above complaint allegation. LPA met with Heather Jenkins, Site Supervisor, who the complaint was gone over. Director Laura Perez took LPA on a tour of the facility.

During the course of this investigation, LPA conducted Interviews, received and reviewed documents as well as obtained declarations.

Reporting Requirements: Per complainant, Staff did not ensure reporting requirements were followed. Per interview with the Director, she stated she called the mom and left a message on moms voice mail of the incident. When grandma picked up the child, nobody informed her of an incident that happened with her grandchild, she had just notice the red mark around the child's forehead area and asked what happened? Grandma was the person picking up the child and nobody gave her an incident report as well.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

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 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 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
12/04/2023 and conducted by Evaluator Cynthia Reyes

COMPLAINT CONTROL NUMBER: 33-CC-20231204091531

FACILITY NAME:	KIDDIE ACADEMY OF GLENDORA		FACILITY NUMBER:	198016425
ADMINISTRATOR:	BETH HOLMES		FACILITY TYPE:	830
ADDRESS:	1339 SOUTH GRAND AVENUE		TELEPHONE:	(626) 691-0242
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY:	24	CENSUS: 12	DATE:	12/07/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Heather Jenkins, Site Supervisor		TIME COMPLETED:	04:25 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Care and supervision
Personal Rights

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analysts (LPA) Cynthia Reyes conducted an unannounced site inspection to investigate the above complaint allegations. LPA met with Heather Jenkins, Site Supervisor, who the complaint was gone over and Director Laura Perez who took LPA on a tour of the facility.

During the course of this investigation, LPA conducted Interviews, and received and reviewed documents.

Care and supervision: Staff did not ensure adequate care and supervision was provided to infant in care and Personal Rights: Infant child sustained an unexplained injury while in care. Per complainant it was stated that staff did not know what happened to the child when grandmother asked what happen when she picked up the child from the day care and notice a red mark on the child's forehead. Per interviews with staff, it was stated that the mom was notified by a phone call and a message left on her voice mail after the incident occurred during the day and when grandmother picked up the child at the end of the day.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 33-CC-20231204091531

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIDDIE ACADEMY OF GLENDORA	FACILITY NUMBER: 198016425
	VISIT DATE: 12/07/2023

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

Page 2

Per interview with the teacher she stated she explained to the grandmother how the incident occurred and that she witness the child walk wobbly and fall and hit his head slightly scrapping his forehead area of his head against the wall and she ran to him and picked him up off the ground as he had fallen and cried a little. Teacher comforted him and checked him for any bleeding or cause of a concussion, but she only observed a very small scrap. Teacher stated she had attended to the child right away. The child has long hair on his forehead and the mark was a slight scrap and was hard to see. However during other interviews It was also stated that the teacher forgot to notify the administrative staff of the incident that occurred early in the day and the teacher ended up telling the director after the grandma had left from picking up the child. It was also stated that the incident report was not written up until after the grandmother left from picking up the child.

Based on interviews, and records reviewed and received, the above allegations are deemed UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted, and a copy of this report was provided to Heather Jenkins, Site Supervisor, and the Notice of Site Visit and Appeal Rights.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 33-CC-20231204091531

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIDDIE ACADEMY OF GLENDORA	FACILITY NUMBER: 198016425
	VISIT DATE: 12/07/2023

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

Page 2

Nobody at the day care spoke verbally to mom until after the child was picked up from the day care, by grandma in the evening. Per interviews it was stated that the mom never got a copy of the incident report because the Director wanted to give it to the mom and did not give it to the grandmother who picked up the child as she stated she thought that was protocol to give to the parent. Mom ended up dis-enrolling the child that same night by a telephone call with the director and never received the incident report.

Based on LPA interviews conducted and documents reviewed and received, the preponderance of evidence standard has been met, therefore, the above allegation is found to be substantiated. California Code of Regulations (Title 22 Division & Chapter), is being cited on the attached deficiencies page LIC 9099D.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Heather Jenkins, Site Supervisor

Page 2 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 33-CC-20231204091531

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIDDIE ACADEMY OF GLENDORA	FACILITY NUMBER: 198016425
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/07/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/15/2023 Section Cited CCR 101226(a)(2)	1 2 3 4 5 6 7	Health-Related Services: In the case of less serious injuries including, but not limited to, minor cuts, scratches and bites from other children requiring assessment and/or administration of first aid by staff, the licensee shall document the injury in the child's record and notify the child's	1 2 3 4 5 6 7	Director states will document the steps they will take to ensure all parents or authorized representatives are made aware of a child injury weather minor or major. Director states will send by the POC date.
	8 9 10 11 12 13 14	authorized representative of the nature of the injury when the child is picked up from the center. This requirement was not met as evidenced by: Staff did not notify the parent properly of an injury a child sustained. This poses a potential risk to the health and safety of 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.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

Page: 5 of 5