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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020404
Report Date: 03/14/2024
Date Signed: 03/14/2024 01:11:05 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
02/12/2024 and conducted by Evaluator Anomeh Eivazian
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240212111344
FACILITY NAME:DISNEY CHILDREN'S CENTERFACILITY NUMBER:
198020404
ADMINISTRATOR:ELISHA GONZALEZFACILITY TYPE:
830
ADDRESS:625 PAULA STTELEPHONE:
(818) 931-5437
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY:54CENSUS: 46DATE:
03/14/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Elisha Gonzalez, DirectorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff left day care child unsupervised while in care.
Staff are not reporting incident(s) involving day care child(ren) as necessary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection to the above facility for the purpose of delivering the complaint finding. LPA arrived at 11:30 AM on 03/14/24. LPA met with Elisha Gonzales, Director who guided analyst on a tour of the facility. During this inspection 46 children were present in the facility with 22 staff.

During this investigation LPA conducted interviews with four staff. LPA obtained copies of Disaster drill log for 2024. Room 3/4 children Transitions Report for 01/26/24, and Staff Attendance Summary Report. LPA took pictures from Room 3/4 yard.

Based on four staff interviews, on 01/26/24, a fire drill was conducted at 10:32 AM. On 01/26/24, during fire drill, staff #2, staff#3 and staff#4 were present in Room#3 and total of 10 children were present in Room 3/4. Per staff#2, staff#3 and staff#4, right before fire drill, staff#3 took child#1 inside the Room #3 from
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: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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-20240212111344
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: DISNEY CHILDREN'S CENTER
FACILITY NUMBER: 198020404
VISIT DATE: 03/14/2024
NARRATIVE
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outside who fell asleep and placed in the crib in the nap room. At that time, staff#4 was in Room 3 with two awake infants. Per staff#4, she completed name to face log at ipad. Shortly after, fire drill alarm went off, staff#3 went inside the Room 3, grabbed two awake infants, at the same time staff#4 got the evacuation crib, went outside from side door, staff#3 took two infants outside from sliding door and placed them in the crib, while staff #3 was by the Room 3 sliding door frame, staff#2 did the children head count and counted 9 children for Room 3/4. Staff#3 went inside and got child#1. Per three staff interviews, the transition from the time that fire drill alarm went off to count the Room 3/4 children, to find out child#1 was left in the nap room was so quick, maybe less than 30-40 seconds.

Based on the Fire Drill log, a fire drill was conducted on 01/26/24 at 10:32 AM. Based on Children Transitions Report on 01/26/24, child #1 was taken inside Room 3 at 10:30 AM.

Based on four staff interviews, this incident was not reported to child#1 parents.

Based on LPA observations and interviews which were conducted and record reviews, the preponderance of
evidence standard has been met; therefore the above allegations are found to be Substantiated at this time.
California Code of Regulations, 101229(a)(1)-- Responsibility for Providing Care and Supervision--(a)
The licensee shall provide care and supervision as necessary to meet the children's needs. (1)
No child(ren) shall be left without the supervision of a teacher at any time, except as specified in
Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation, and
101212(f)—Reporting Requirements-- The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative are being cited on the attached LIC9099D.

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 Elisha Gonzales at 1:30 PM.
REPORT END 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20240212111344
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: DISNEY CHILDREN'S CENTER
FACILITY NUMBER: 198020404
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/22/2024
Section Cited
CCR
101229(a)(1)
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 Responsibility for Providing Care and Supervision
No child(ren) shall be left without the supervision of a teacher at any time, etc...
This requirement was not met as evidenced by...
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Per director, she will review Fire Drill steps with all staff to ensure no child(ren) left unsupervised. A copy of staff sign in sheet and topics that will be discussed will be emailed to LPA.
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Based on four staff interviews, on 01/26/24, child#1 was left alone in Room 3 nap room for about 30-40 seconds while staff were by the Room 3 glass door.
This poses a potential health, safety and personal right risk to the children in care.
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$250 Civil Penalty was accessed for repeated violation with 12 months.
Type B
03/23/2024
Section Cited
CCR
101212(f)
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Reporting Requirements
The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative.
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Per director, this incident will be reported to child#1 parent in writing and verbal by 03/22/24, and a copy of written note will be submitted to LPA.
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Based on four staff interviews, on 01/26/24, child#1 was left alone in Room 3 nap room for about 30-40 seconds while staff were by the Room 3 glass door and this incident was not reported to child#1's parent. This poses a potential health, safety and personal right risk to the 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: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3