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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419435
Report Date: 02/22/2024
Date Signed: 03/21/2024 09:45:23 AM

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
12/06/2023 and conducted by Evaluator Joe Katrdzhyan
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20231206133218
FACILITY NAME:LITTLE TREEHOUSE ACADEMYFACILITY NUMBER:
197419435
ADMINISTRATOR:ANNA SHIROKOVAFACILITY TYPE:
850
ADDRESS:18510 PLUMMER STREETTELEPHONE:
(818) 772-9320
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:85CENSUS: 28DATE:
02/22/2024
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Director / Anna ShirokovaTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff handled daycare child in a rough manner.
INVESTIGATION FINDINGS:
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***This is an amended report which supersedes the previous report***

On 2/22/24, at 8AM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an unannounced visit to this facility to deliver findings on the above-mentioned allegation. Upon arrival, LPA met with Director / Anna Shirokova, who guided LPA on a tour of the facility. There were 28 children with 5 staff observed present. LPA explained the purpose of today’s visit.

During the course of the investigation, interviews were conducted and copies of Children's / Staff Rosters were obtained/reviewed.

Per Reporting Party, Staff handled daycare child in a rough manner.

During the interview with the Director, the Director denied having knowledge about the alleged incident,
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
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 58-CC-20231206133218
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: LITTLE TREEHOUSE ACADEMY
FACILITY NUMBER: 197419435
VISIT DATE: 02/22/2024
NARRATIVE
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involving a Staff handling Child in a rough manner.

During the interview with the Assistant Director, the Assistant Director disclosed that Staff 2 made a disclosure of Staff 1 mishandling a Child in a rough manner. It was also disclosed that Staff 1 was removed from their position temporarily and placed in the office and assigned office related work. Counseling was provided to Staff 1 regarding handling children in a rough manner.

During the interview with Staff 3, it was disclosed that Staff 3 has observed Staff 1 on multiple occasions handling children in a rough manner.

Parents interviewed did not present concerns related to the above-mentioned allegation and were pleased with the services and care being provided to their children.

LPA made attempts to interview children but was unsuccessful.

Based on LPA’s observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22, Division & Chapter number), is being cited on the attached LIC 9099D.

The Notice of Site Visit was provided and 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.

Exit interview was conducted with Director / Anna Shirokova and Appeals Rights provided.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 58-CC-20231206133218
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: LITTLE TREEHOUSE ACADEMY
FACILITY NUMBER: 197419435
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/04/2024
Section Cited
CCR
101223(a)(3)
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Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement was not met as evidenced by:
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The Licensee will conduct an in-service training with all staff on the importance of ensuring compliance within this section. Copies of the training along with signatures of all attendees will be submitted to CCL by the POC due date.
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The Assistant Director disclosed that Staff 2 made a disclosure of Staff 1 mishandling a Child in a rough manner. It was also disclosed that Staff 1 was removed from their position temporarily and placed in the office and assigned office related work. Counseling was provided to Staff 1 regarding handling children in a rough manner. During the interview with Staff 3, it was disclosed that Staff 3 has observed Staff 1 on multiple occasions handling children in a rough manner. This poses a potential health, safety, and personal rights to 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: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3