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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198017983
Report Date: 11/07/2022
Date Signed: 11/08/2022 10:00:56 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
10/28/2022 and conducted by Evaluator Judy Mora
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20221028102720
FACILITY NAME:WILLIAM MEAD HEAD START/STATE PRESCHOOLFACILITY NUMBER:
198017983
ADMINISTRATOR:MARCIE HOUCHENFACILITY TYPE:
850
ADDRESS:120 LEROY STREETTELEPHONE:
(323) 505-7230
CITY:LOS ANGELESSTATE: CAZIP CODE:
90012
CAPACITY:30CENSUS: 7DATE:
11/07/2022
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Alma Rodriguez TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Faciliy staff did not report an outbreak as required.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced site inspection on this date to investigate the above complaint allegation. LPA met with Child Development Specialist, Alma Rodriguez and Teacher Leticia Ramirez. LPA observed 7 children present with 03 staff.

During the course of this investigation LPA conducted interviews with staff. Disclosures were made during interviews which verify that no staff present at the facility reported the outbreak to the Licensing Department. Upon entrance to the classroom, LPA observed publications posted outdoors near the entrance of the classroom in regards to the outbreak diagnosis(photograph taken). LPA verified in FAS that no Unusual Incident Report was received by the Department within 24 hours of occurence and/or within 7 days in writing as required. LPA found that during the week of 10/24/22, there was a Hand, Foot and Mouth outbreak at the facility and it was not reported to the Department.



*REPORT CONTINUES ON NEXT PAGE
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2022
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
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
10/28/2022 and conducted by Evaluator Judy Mora
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20221028102720

FACILITY NAME:WILLIAM MEAD HEAD START/STATE PRESCHOOLFACILITY NUMBER:
198017983
ADMINISTRATOR:MARCIE HOUCHENFACILITY TYPE:
850
ADDRESS:120 LEROY STREETTELEPHONE:
(323) 505-7230
CITY:LOS ANGELESSTATE: CAZIP CODE:
90012
CAPACITY:30CENSUS: 7DATE:
11/07/2022
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Alma Rodriguez TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility staff did not prevent an outbreak.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced site inspection on this date to investigate the above complaint allegation. LPA met with Child Development Specialist, Alma Rodriguez and Teacher Leticia Ramirez. LPA observed 7 children present with 03 staff.

During the course of this investigation LPA conducted interviews with staff. Disclosures were made during interviews which verify that no staff present at the facility reported the outbreak to the Licensing Department. Upon entrance to the classroom, LPA observed publications posted outdoors near the entrance of the classroom in regards to the outbreak diagnosis(photograph taken). LPA found that during the week of 10/24/22, there was a Hand, Foot and Mouth outbreak at the facility and it was not reported to the Department.

Although the allegation may have happened or is valid there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.
Exit interview was conducted with Alma Rodriguez. Appeal rights provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 33-CC-20221028102720
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: WILLIAM MEAD HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 198017983
VISIT DATE: 11/07/2022
NARRATIVE
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Based on the available information, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations,(Title 22, Division 12 & Chapter Number 1), are being cited on the attached LIC. 9099D'S.

Upon receipt of this report, the licensee shall post any licensing report documenting a type “A” citation and/or a substantiated complaint. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care for up to one year.

A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted with Alma Rodriguez, Child Development Specialist. Appeal Rights explained and provided.


*END OF REPORT, SEE LIC 9099D
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 33-CC-20221028102720
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: WILLIAM MEAD HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 198017983
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/11/2022
Section Cited
CCR
101212(d)(1)(E)
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REPORTING REQUIREMENTS
Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information
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Child Development SUpervisor will remind people in charge fo reporting to report incidents to licensing. An Unusal Incident Report will be submitted within 24 hours.
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specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
Events reported shall include the following:
Epidemic outbreaks.
This requirement was not met as evidenced by staff disclosures and file review. During the week of 10/24/22 there was a Hand, Foot and Mouth outbreak at the facility and it was not reported to licensing as required. This is a potential risk to the health and safety of 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: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4