<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198021129
Report Date: 05/11/2023
Date Signed: 05/11/2023 11:04:01 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
05/05/2023 and conducted by Evaluator Anomeh Eivazian
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20230505131000
FACILITY NAME:WESTSIDE JEWISH COMMUNITY INFANT CENTERFACILITY NUMBER:
198021129
ADMINISTRATOR:FRIEDMAN, LAURENFACILITY TYPE:
830
ADDRESS:5870 WEST OLYMPIC BLVDTELEPHONE:
(323) 556-5202
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY:18CENSUS: 11DATE:
05/11/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lauren Friedman, DirectorTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Daycare child sustained an unexplained burn injury while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection to the above facility on 05/11/23 regarding above allegation. LPA arrived at 9:30 a.m. and met with Lauren Friedman, director who guided analyst on a tour of the facility. During this inspection there were 11 infants present in the facility with 5 staff.

During this investigation, LPA Eivazian conducted interviews with staff#1/parent#1 and staff#2. LPA obtained pictures from child#1's arm, dated 05/03/23 with injury and no injury and a copy of Doctor report dated 05/03/23.

An Unusual incident report related to this complaint allegation was submitted to LPA Eivazian via email by director on 05/05/23 at 3:51 PM. Per director she contacted Monterey Park Regional office on 05/04/23 and left a voicemail for officer on duty.

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: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
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 3
Control Number 33-CC-20230505131000
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: WESTSIDE JEWISH COMMUNITY INFANT CENTER
FACILITY NUMBER: 198021129
VISIT DATE: 05/11/2023
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
Based on staff#1 and staff#2 interviews, on 05/03/23 child#1 came to the school with no mark on left arm. (Pictures were provided). Per staff#1 and staff#2, on 05/03/23 in the afternoon child#1 got red mark on left arm.

Per staff#1, who is also the child#1's parent, child#1 was taken to the Doctor on 05/03/23 for treatment. Per staff#1/parent#1, child#1 was diagnosed with first degree burn. The wound was treated and bandaged.

Based on LPA observations and interviews which were conducted, the preponderance of evidence standard has been meet, therefore the above allegation was found to be Substantiated at this time. California Code of Regulations- 101223 (a) (2)--Personal Rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs, are being cited on the attached LIC9099D.

LPA Anomeh Eivazian informed director, Lauren Friedman that this report dated 05/11/2023 document(s) 1 of Type A citation. Type A citations which shall be posted for 30 consecutive days as there are immediate risk(s) to the health, safety, or personal rights of children in care.



Also, LPA Anomeh Eivazian informed the director, Lauren Friedman to provide a copy of this licensing report dated 05/11/2023 that document 1Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the director, Lauren Friedman at 11:30 a.m..
REPORT END 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20230505131000
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: WESTSIDE JEWISH COMMUNITY INFANT CENTER
FACILITY NUMBER: 198021129
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/12/2023
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
Personal Rights
The licensee shall ensure that each child is accorded the following personal rights:
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by ...
1
2
3
4
5
6
7
Per director, Lauren Friedman going forward is not to bring any child into the kitchen. A different appliance for heating bottles that is smaller and can sit far back on the counter was purchased.
8
9
10
11
12
13
14
Based on staff#1 and staff#2 interviews and unusual incident report that was submitted on 05/05/23, child#1 got red mark on 05/03/23 on left arm and was diagnosed with the first degree burn by a Doctor. This poses an immediate health, safety and personal right risks to the children in care.
8
9
10
11
12
13
14
$250 Civil Penalty was assessed today for repeated violation within 12 months.
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.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3