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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197400632
Report Date: 01/05/2023
Date Signed: 01/05/2023 11:56:30 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2022 and conducted by Evaluator Lillian J Casillas
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20221108152905
FACILITY NAME:WORLDTOTS LAFACILITY NUMBER:
197400632
ADMINISTRATOR:PAMELA DALEFACILITY TYPE:
850
ADDRESS:100 W. FIFTH STREETTELEPHONE:
(310) 732-7697
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:48CENSUS: 22DATE:
01/05/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Pamela DaleTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Neglect/Lack of Supervision: Facility staff did not assist child that had their hair stuck in a gate
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 1/5/2023, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced complaint investigation to deliver the findings regarding the allegation listed above. LPA met with Administrator, Pamela Dale, and explained the purpose of the visit. LPA observed 22 children with 8 staff.

On 11/16/2022, LPA Casillas conducted an unannounced inspection to initiate the complaint investigation. LPA met with Administrator, Pamela Dale, and conducted a tour of the inside and outside of the facility. LPA interviewed the Administrator and 3 staff. LPA also reviewed the files for Child 1 and Child 2, the LIC 624 Unusual Incident Report submitted to the Department on 11/8/2022, and incident reports written by Staff 1, Staff 2, and Staff 4. LPA also obtained LIC 855 Declaration forms from 3 staff members involved in the incident.

[CONTINUE ON PAGE 2]
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023
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 2
Control Number 30-CC-20221108152905
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WORLDTOTS LA
FACILITY NUMBER: 197400632
VISIT DATE: 01/05/2023
NARRATIVE
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10
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PAGE 2

Based on interviews, record review, and observations conducted and obtained during the investigation, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was provided to Administrator, Pamela Dale, along with Appeal Rights and the LIC 9213 Notice of Site Visit.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2