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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198016791
Report Date: 06/03/2021
Date Signed: 06/03/2021 12:52:00 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/22/2021 and conducted by Evaluator Fabiola Vasquez
COMPLAINT CONTROL NUMBER: 33-CC-20210322140011
FACILITY NAME:KINDER KOUNTRY ACADEMYFACILITY NUMBER:
198016791
ADMINISTRATOR:LUCY SALAZARFACILITY TYPE:
850
ADDRESS:456 W. SAN JOSE AVE #BTELEPHONE:
(909) 621-0226
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:27CENSUS: 12DATE:
06/03/2021
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Anna VartevaryanTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff is recording children fighting.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility on 06/03/21 via telephone by Facetime due to COVID-19 and precautionary measures. LPA spoke with Ana Varyevaryan, Administrator. LPA identified herself and stated the purpose of the contact is to provide the findings for the above allegation, Staff is recording children fighting. The call was transferred to FaceTime to complete the virtual tele-inspection tour of the facility. Census: 12 Staff: 3

During the investigation, interviews were conducted with the Reporting Party, Witness, S1, S2, S3, S4, C3. Attempted interviews were conducted with C1, C2. LPA obtained a copy of a snapchat shot, children's roster, daily schedule, personnel report, visitors log received for May 2021, children’s sign in sheets for the months of 8/1/20-8/31/20.


*REPORT CONTINUES ON NEXT PAGE*
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021
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 2
Control Number 33-CC-20210322140011
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDER KOUNTRY ACADEMY
FACILITY NUMBER: 198016791
VISIT DATE: 06/03/2021
NARRATIVE
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Based on the evidence obtained during the investigation through, interviews, observations, and review of records, there were no disclosures made that support the allegation, that staff is recording children fighting. It was undetermined if the children fighting were day care children enrolled in facility or family of person taking the video. It is unclear if a volunteer or a full-time staff took the video or where the video was taken, what day or time of day it was taken.

Due to information and statements obtained during interviews conducted, the allegation has been determined to be Unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit phone interview has been conducted with Administrator Ana Varyevaryan. Appeal Rights were verbally explained and provided to Administrator as well. A copy of this report (LIC 9099) along with the Appeal Rights LIC ( 9058) has been signed by LPA Vasquez. This report along with the Appeal Rights will be scanned via e-mail to the Administrator, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report, and the Appeal Rights will be mailed, and the Administrator agrees to sign the bottom of each page of the LIC 9099 and return the originals to LPA Vasquez in-person or via U.S. Mail. A Notice of Site Visit was not provided to Licensee since a physical inspection was not conducted.


*REPORT ENDS HERE*
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2