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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197417299
Report Date: 06/26/2023
Date Signed: 06/26/2023 03:49:28 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
02/02/2023 and conducted by Evaluator Silva Garibyan
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230202111500
FACILITY NAME:UCLA WESTWOOD CHILD CARE CENTERFACILITY NUMBER:
197417299
ADMINISTRATOR:NICOLE FIORELLAFACILITY TYPE:
830
ADDRESS:10861 WEYBURN AVENUE #301TELEPHONE:
(310) 481-0664
CITY:LOS ANGELESSTATE: CAZIP CODE:
90024
CAPACITY:63CENSUS: 47DATE:
06/26/2023
UNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Jennie Lopez, Center DirectorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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1) Staff did not provide adequate supervision to a daycare child while in care
2) Staff provided a daycare child with not an age appropriate material while in care
3) Staff did not seek timely medical attention for a daycare child
INVESTIGATION FINDINGS:
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An unannounced follow-up Complaint inspection was conducted on 06/30/2023 by Licensing Program Analyst (LPA) Silva Garibyan. The purpose of the inspection is to deliver the findings of a complaint investigation which was conducted by Investigations Branch (IB) Investigator Dennis Seng.

Upon arrival, LPA took/requested census; per Jennie Lopez, there were 15 staff with 47 children. Staff-child ratio was met. All staff have Criminal Background Clearance and are associated to the facility.

Throughout the course of the investigation, interviews were conducted with four adults and five staff; and documentation in the form of medical records, staff schedules, facility policies, and photographs were obtained.

IB Investigator Seng verified that Child #1 (DOB 04/05/20) was enrolled in and attending the Center on 06/06/21, the date of the incident. The incident occurred on or about June 6, 2021. Page 1
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
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 7
Control Number 58-CC-20230202111500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: UCLA WESTWOOD CHILD CARE CENTER
FACILITY NUMBER: 197417299
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/30/2023
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision: The licensee shall provide care and supervision as necessary to meet the children's needs. 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.
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 Director will conduct an In-Service training with staff with emphasis on visual Supervision and watch the “Supervising children in child care” video at CCLD.childcarevideos.org. Director will provide a copy of training agenda, sign in sheet, submit a LIC 855 Declaration, .

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This requirement is not met as evidenced by: zero of the three staff present observed an incident which occurred with Child #1 during which C1 tripped/lost their balance and fell on a wooden spoon resulting in a hole under the tongue *This poses an immediate health, safety or personal rights risk to the children in care.*

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 via email summarizing the regulation and information learned in the video to LPA no later than 06/30/2023
Request Denied
Type A
06/30/2023
Section Cited
CCR
101223(a)(2)
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101223 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 is not met as

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After the incident the facility removed all utensils from their Loose Parts Program due to their determination that it was inappropriate to provide to infants. Director will conduct an In-Service training with staff with emphasis on Personal Rights and watch the “Children’s Personal
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evidenced by:: Child #1 tripped or lost their balance and fell while either carrying a wooden spoon in their hand or in their mouth, sustaining serious damage to their mouth. *This poses an immediate health, safety or personal rights risk to the children in care.*
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 Rights in child care” video at CCLD.childcarevideos.org.
Director will provide a copy of training agenda, sign in sheet, submit a LIC 855 Declaration, .via email summarizing the
egulation and information learned in the video to LPA no later than 06/30/2023
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: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 58-CC-20230202111500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: UCLA WESTWOOD CHILD CARE CENTER
FACILITY NUMBER: 197417299
VISIT DATE: 06/26/2023
NARRATIVE
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 The incident occurred while infants were participating in a “Loose Parts Program” at the Center. During this program, household items (in particular, kitchen utensils, Tupperware, spoons, cloth and other articles of clothing) are left out in the classroom and are accessible (i.e. left on the floor) to the children throughout the day to allow the infants to learn and gain familiarity with these everyday items “to freely explore under supervision.” The incident which occurred is an infant (Child #1) was holding a wooden spoon and walked and tripped or lost their balance and fell on the spoon or was walking with the spoon in their mouth and tripped or lost their balance and fell with the spoon still in their mouth; the spoon hit the floor and lacerated the base of the mouth, severing a blood vessel and chipping the teeth of Child #1. As a result, Child #1 will likely require braces and three additional surgeries to reposition their Temporomandibular Joint Injury.

-Pertaining to the allegation that “Staff did not provide adequate supervision to a day-care child while in care”:

This allegation pertains to whether or not the staff in the classroom the day of the incident provided adequate supervision to Child #1.

Three of the five staff interviewed corroborated that there were three staff in the room the day of the incident and that the Center maintained a ratio of one staff to three infants, which exceeds the Community Care Licensing required ratio of one staff to four infants. Three of the five staff interviewed were the staff present in the classroom the day of the incident. Of the three staff, one recalled seeing Child #1 with a wooden spoon in their hand and no staff actively exploring the spoon with Child #1; while another staff recalled observing one staff standing within four feet of Child #1, but the staff was not actively exploring the spoon with Child #1 and was not actively watching Child #1 because the staff’s attention was on the other infants.

Based upon both staff’s admissions of seeing Child #1 with a wooden spoon in their mouth and the staff standing within four feet of Child #1 not actively supervising or exploring the spoon with Child #1, the allegation that “Staff did not provide adequate supervision to a day-care child while in care” has been determined to be Substantiated.

A finding of Substantiated means that the preponderance of evidence standard has been met. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06, Section 101229 “Responsibility for Providing Care and Supervision” is being cited on the attached LIC 9099D. Page 2
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC9099 (FAS) - (06/04)
Page: 7 of 7
Control Number 58-CC-20230202111500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: UCLA WESTWOOD CHILD CARE CENTER
FACILITY NUMBER: 197417299
VISIT DATE: 06/26/2023
NARRATIVE
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-Pertaining to the allegation that “Staff provided a daycare child with not an age-appropriate material while in care”:

This allegation pertains to whether or not a long handled wooden spoon would be considered to be “age-appropriate” for a child under the age of 2 or not.

Per the facility’s policy for their Loose Parts Program, “The following items are prohibited in classrooms that serve children younger than three (3) years of age: items that fit in the choke tub; small, ingestible art supplies (e.g. glitter and small cotton balls, feathers & pom poms); Styrofoam products or pieces (e.g. packing peanuts). Artwork displays using staples, thumbtacks, push pins, small magnets, or frames with glass. Instead, tape, magnetic tape, Velcro, sticky tack, plastic box frames, and DocU Pockets (available on BrightBuy) should be used in younger classrooms and common area displays. Item which are prohibited for this age group, per product directions or guidelines…The following Toxic/Dangerous items may be present in a classroom but must be out of the reach of and inaccessible to children (see Storage section below):…sharp objects.”

Though the handle of the wooden spoon appears to be long and wooden, it does not appear to be sharp, nor does anywhere else on the spoon appear to be sharp. In other words, the wooden spoon would appear to be “age-appropriate” for an infant who is, by definition, younger than three years of age.

However, three of the nine persons interviewed stated that they do not believe that the wooden spoon was “age-appropriate.”

When asked how to gauge whether or not a toy would be deemed to be “age-appropriate” for an child under the age of 2, one of the nine staff interviewed stated that “they use a measuring cup to gauge which toys are appropriate, and the measuring cup is used to prevent a choking hazard…the objects at the facility must not be able to fit inside the measuring cup in order to be considered age appropriate.” Per this staff, “the wooden spoon was too large to fit inside the measuring cup” and was thus deemed age-appropriate for infants to play with. However, when asked by IB Investigator Seng if it were possible for an object to be too large to fit inside the measuring cup and still not be considered to be age-appropriate, the staff concurred.

After this incident, five of the nine staff state that “such items” or “such utensils” “kitchen utensils” or the wooden spoon in particular are no longer allowed in the curriculum, as their policy was adjusted and the Center “decided that spoons were not a safe option to have in the environment.” Page 3

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 58-CC-20230202111500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: UCLA WESTWOOD CHILD CARE CENTER
FACILITY NUMBER: 197417299
VISIT DATE: 06/26/2023
NARRATIVE
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Thus, based upon staff’s own admission, the allegation that “Staff provided a daycare child with not an age-appropriate material while in care” has been determined to be Substantiated.

A finding of Substantiated means that the preponderance of evidence standard has been met. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06, Section 101223 “Personal Rights” is being cited on the attached LIC 9099D.

-Pertaining to the allegation that “Staff did not seek timely medical attention for a day-care child”:

By all accounts, after Child #1 fell on the wooden spoon, child was bleeding profusely from their mouth onto their shirt. Child’s mouth was rinsed, gauze or a paper towel was placed in the child’s mouth with pressure to stop the bleeding, child was given a cold teether to stop the bleeding, child was held since child was crying, and then child was put to nap in their crib. After notifying child’s parent, staff notified the Director and completed an internal Special Incident Report, as it was determined that parents would be seeking medical treatment.

By all accounts, parent was notified at 03:00 PM. Though parent was told by the notifying staff that the incident had occurred at around 02:00 PM, Staff #3 corroborated that though the incident had occurred around 10:30 am, the parents of Child #1 were not notified until 03:00 PM because “the class was busy that day.” However, the usual “policy is to notify the parents of any injuries above the neckline before 30 minutes.” Staff #2 acknowledged that parents should have been notified sooner, but “because (Child #1) fell asleep fast…and woke up happy,” Staff #2 tried to feed the child a cracker instead of seeking help. When asked why 911 was not phoned, Staff #5 stated that “initially, there was a lot of blood coming from (Child #1’s) mouth, but with any cut to the head, there’s usually a lot of blood. But it stopped after a short period of time.” After child took a nap and the bleeding stopped, Staff #5 did not “think 911 was necessary for mouth injuries” because “they bleed a lot,” only “if there was a loss of consciousness.” Per Adult #2, the injury “required immediate treatment because we wouldn’t have any idea how badly it was bleeding, and just by reading (Child #1’s records,) it appeared concerning because of the risk of a possible infection.”

Thus, based upon staff’s own admission to not immediately reporting the injury to the parents of Child #1 nor phoning 911 and based upon Adult #2’s statement that “the injury required immediate treatment,” the allegation that “Staff did not seek timely medical attention for a day-care child” has been determined to be Substantiated. Page 4


SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 58-CC-20230202111500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: UCLA WESTWOOD CHILD CARE CENTER
FACILITY NUMBER: 197417299
VISIT DATE: 06/26/2023
NARRATIVE
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A finding of Substantiated means that the preponderance of evidence standard has been met. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06, Section 101223 “Personal Rights” is being cited on the attached LIC 9099D. In addition, a civil penalty in the amount of $500 for the seriousness of the injury to Child #1 is being assessed.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

A copy of this Report (LI9099s/9099D), Appeal Rights (LIC9058), and Notice of Site Visit were reviewed and provided to the Director, Jennie Lopez.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 58-CC-20230202111500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: UCLA WESTWOOD CHILD CARE CENTER
FACILITY NUMBER: 197417299
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/30/2023
Section Cited
CCR
101226(a)
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Health-Related Services
(a) The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch. The licensee shall obtain specific instructions from the authorized representative regarding action to be
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: Licensee will submit a plan that delineates the understanding and implementation of this regulation. Licensee will submit a copy of a detailed procedural memo instructing staff of actions to take in the event of an injury. A copy of this memo is due by 06/30/23.
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taken.
This Requirement is not met as evidenced by: Child sustained a serious injury, Facility did not call 911 or timely report the incident to his/her parents. *This poses an immediate health, safety or personal rights 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: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC9099 (FAS) - (06/04)
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