191500557-9-19-2023-33-CC-CGAN-CWC2RX-20231005173812

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191500557
Report Date: 09/19/2023
Date Signed: 09/19/2023 11:39:25 AM

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
09/14/2023 and conducted by Evaluator Mary Silva

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20230914120330

FACILITY NAME:	FIRST CHRISTIAN CHURCH CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191500557
ADMINISTRATOR:	LILIANA VASQUEZ		FACILITY TYPE:	850
ADDRESS:	1751 N PARK AV		TELEPHONE:	(909) 629-3636
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY:	60	CENSUS: 5	DATE:	09/19/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Director Hilda Ontiveros-Koorn		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Hazards on the facility playground pose a risk to children in care

INVESTIGATION FINDINGS:

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

On 09/19/2023, Licensing Program Analyst (LPA) Mary Silva conducted an unannounced 10-day complaint inspection and to deliver findings to the above allegation. The purpose of the inspection was explained. LPA met with Director, Hilda Ontiveros-Koorn, who guided LPA on a tour of the facility. There was a total of 5 children present with 1 staff. The facility has four classrooms and due to low enrollment one classroom is being utilized.

Complainant alleged that hazards on the facility playground pose a risk to children in care. Complainant stated a tree in the play area is lifting the cement from the ground.

During this inspection LPA conducted an interview with director and obtained copy of the facility roster and personnel report. LPA observed a tree in the middle of the preschool playground surrounded by a square of uneven cement lifting from the ground causing a tripping hazard to the children in care. LPA obtained photographs of the outdoor playground. Page 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary Silva	TELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

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-20230914120330

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: FIRST CHRISTIAN CHURCH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191500557
	VISIT DATE: 09/19/2023

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 LPA observation, and photographs obtained of the outdoor space the preponderance of evidence standard has been met, therefore, the above allegations are found to be substantiated. California Code of Regulations (Title 22 Division & Chapter), are being cited on the attached deficiencies page LIC 9099-D.

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 Director, Hilda Ontiveros-Koorn.

Page 2 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Mary Silva	TELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20230914120330

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: FIRST CHRISTIAN CHURCH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191500557
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/19/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/19/2023 Section Cited CCR 101238.2(d)(1)	1 2 3 4 5 6 7	101238.2 Outdoor Activity Space (d) The surface of the outdoor activity space shall be maintained: (1)In a safe condition for the activities planned. This requirement is not meet as evidence by:	1 2 3 4 5 6 7	Director stated a yellow caution tape will be temporaly placed around the tree to keep children from walking over the uneven cement. Per director a patch of cement will be added to even the lifted area and a wooden fence will be installed to surround the tree. Facility will email a picture to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interviews with the director and LPA's observations. LPA observed a tree in the preschool playground surround by a square of uneven cement lifting from the ground which poses a potential risk and safety to 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: Mary Silva	TELEPHONE: (323) 558-2711
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3