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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494730
Report Date: 04/30/2021
Date Signed: 04/30/2021 03:01:15 PM

Substantiated


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
02/09/2021 and conducted by Evaluator Angelica Ramirez
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210209140816
FACILITY NAME:SHEPHERD'S FOLD PRESCHOOL - GARDENAFACILITY NUMBER:
197494730
ADMINISTRATOR:INGERSOLL, TROY PAULFACILITY TYPE:
850
ADDRESS:1409 W. 182ND STREETTELEPHONE:
(310) 227-9314
CITY:GARDENASTATE: CAZIP CODE:
90248
CAPACITY:75CENSUS: 14DATE:
04/30/2021
ANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Laura ChascoTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Day care child received an injury while in care.
Staff handled child in care in a rough manner.
INVESTIGATION FINDINGS:
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On 4/30/2021 at 2:00 PM Licensing Program Analyst (LPA) Angelica Ramirez conducted an announced tele-inspection call with Director Laura Chasco (via Microsoft Teams) due to the current public health crisis (COVID-19). LPA advised the reason for the call is to deliver the findings of the complaint received on 2/9/2021 regarding the allegations referenced above. LPA observed a total of 14 children with 2 staff, all adults have a criminal record clearance.

Based on interviews conducted with the reporting party, parents and staff, and documents obtained, the allegations referenced above are Substantiated. During the investigation, LPA found that an incident took place between Child #1 and Staff #3, where Child #1 climbed on top of a desk and Staff #3 grabbed the child to bring him down from the desk. Although Staff #3 was acting in a manner to prevent the child from sustaining a serious injury, the force used was enough to cause a bruise on Child #1. Therefore the allegations are Substantiated, meaning that the allegations are valid because the preponderance of the evidence standard has been met.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Angelica Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2021
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 30-CC-20210209140816
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: SHEPHERD'S FOLD PRESCHOOL - GARDENA
FACILITY NUMBER: 197494730
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/28/2021
Section Cited
CCR
101223(a)(3)
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101223(a)(3) Personal Rights. (a) The licensee shall ensure that each child is accorded... personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation... or other actions of a punitive nature...
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Facility is to provide additional training to staff on addressing challenging behavior in young children by 5/28/2021. The correction will be provided to the Department via fax, mail, or email. LPA provided: Recommended Practices, Preventing Challenging Behavior in Young Children: Effective Practices.
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This requirement was not met as evidenced by: based on interviews conducted, Staff #3 injured Child #1 while attempting to get him off the desk. This poses a potential health and safety risk to children in care.
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LPA also provided the following link ( https://www.virtuallabschool.org/fcc/guidance/lesson-4 ) which provides resources and a video on addressing challenging behavior. Facility is to provide the training to all staff members, provide a sign-in sheet of each staff member who observed the training. Staff #3 is to provide a written statement regarding effective practices learned through training with date and signature.
Type B
05/28/2021
Section Cited
CCR
101223(a)(3)
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101223(a)(3) Personal Rights. (a) The licensee shall ensure that each child is accorded... personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation... or other actions of a punitive nature...
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Facility is to provide additional training to staff on addressing challenging behavior in young children by 5/28/2021. The correction will be provided to the Department via fax, mail, or email. LPA provided: Recommended Practices, Preventing Challenging Behavior in Young Children: Effective Practices.
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This requirement was not met as evidenced by: based on interviews conducted, Staff #3 injured Child #1 while attempting to get him off the desk. This poses a potential health and safety risk to children in care.
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LPA also provided the following link ( https://www.virtuallabschool.org/fcc/guidance/lesson-4 ) which provides resources and a video on addressing challenging behavior. Facility is to provide the training to all staff members, provide a sign-in sheet of each staff member who observed the training. Staff #3 is to provide a written statement regarding effective practices learned through training with date and signature.
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: Karren Starks
LICENSING EVALUATOR NAME: Angelica Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 30-CC-20210209140816
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: SHEPHERD'S FOLD PRESCHOOL - GARDENA
FACILITY NUMBER: 197494730
VISIT DATE: 04/30/2021
NARRATIVE
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Type B deficiencies were cited during today's inspection, see LIC9099-D for details.

An exit interview was conducted via Tele-Visit with Ms. Chasco in which this report was read to her. A copy of this report, Appeal Rights, and a Notice of Site Visit were issued to Ms. Chasco. The Notice of Site Visit is to be posted in a prominent area for 30 days.

A copy of this report is being emailed to Ms. Chasco and it has been explained that a reply to the email shall be considered a substitute for the hard-copy signature.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Angelica Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3