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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198018446
Report Date: 04/19/2022
Date Signed: 04/19/2022 01:52:57 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
02/17/2022 and conducted by Evaluator Seung Lee
COMPLAINT CONTROL NUMBER: 33-CC-20220217112940

FACILITY NAME:EAGLES NEST PRESCHOOLFACILITY NUMBER:
198018446
ADMINISTRATOR:CAMPBELL, JENNIFERFACILITY TYPE:
850
ADDRESS:10262 COLIMA RDTELEPHONE:
(562) 903-1460
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY:58CENSUS: 38DATE:
04/19/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jennifer CampbellTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Daycare child consumed a paperclip while in care.
Daycare child sustained injuries.
Staff did not notify daycare child’s authorized representative of incident involving daycare child.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced complaint inspection. Upon arrival LPA Lee met with Director Jennifer Campbell

During the course of the investigation, LPA Lee conducted interviews, reviewed records, and made observations in regards to the above allegations.

The complaint stated that a child in care had consumed a peper clip at the facility. The complaint stated that the facility contacted the parent of this child on 01/28/21 because the child had consumed a paperclip at the facility. The complaint goes on to state that the paperclip was discovered at the hospital after the child had arrived from the facility. The facility denied this allegation and made no disclosure. The facility stated that the parent was contacted by the facility on 01/28/21 because a paperclip was discovered during a diaper change at the facility. LPA Lee observed what looked to be a screenshot from a text message exchange between the facility and the parent of the child in care. The screenshot showed a picture of a paperclip in a soiled diaper that was sent to the parent by the facility Director on 01/28/21.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 33-CC-20220217112940
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: EAGLES NEST PRESCHOOL
FACILITY NUMBER: 198018446
VISIT DATE: 04/19/2022
NARRATIVE
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The screen shot does show the date and time of the message sent by the facility as 09:12AM on 01/28/21 and also had a note stating that this was the child's first diaper change since arrival that day. The facility stated that the hospital had determined that the child had not swallowed the paper clip after examining the child. It is not clear if this was the actually stated by the doctor that had examined the child based on all the documents observed during the investigation related to this incident. This incident took place in January of 2021. Although it is not clear if the child had actually swallowed the paper clip or not, the facility did contact the parent after the paper clip was observed in a soiled diaper at the facility as evidenced by the screen shot the facility provided.

It is possible that paper clip could have come from either the facility or from the home of the child, but there is no way of determining where the paper clip actually came from and if the child had swallowed the paper clip at all at based on the date of the incident and the evidence collected during the investigation.

The complaint also alleges that the facility did not inform this same parent of incident that involved a child in care sustaining an injury. The complaint goes on to state that on 02/08/2022 the parent observed that their child had sustained an injury on his nose and lip but was not notified by the facility about the incident that caused the injury. The facility denied this allegation and made no disclosure. The facility did provide a copy of an ouch report that was written on 02/07/2022 by a staff member. LPA Lee observed that the date on the bottom of the report was a day later on 02/08/2022. During an interview the staff member that wrote the ouch report stated that she cannot confirm when the report was signed by the parent since the office handles obtaining signatures from parents for ouch report during pick up time. The signature of this report does seem to match the signatures of prior ouch reports observed in the child's file but there is no way to determine for sure. The parent of the child in the complaint stated that the facility did not provide any notice about an injury observed on 02/08/2022. The facility claims that the parent was informed and provided a copy of an ouch report that was created for an incident that occurred on 02/07/2022 and signed by the parent on 02/08/2022.

Based on evidence obtained and observed during the investigation Although the allegation that child consumed a paper clip while in care, child sustained injuries while in care, and facility staff did not notify day care child’s authorized representative of incident involving day care child may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore at this time the above allegations are unsubstantiated.
SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20220217112940
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: EAGLES NEST PRESCHOOL
FACILITY NUMBER: 198018446
VISIT DATE: 04/19/2022
NARRATIVE
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Exit interview conducted with Director Jennifer Campbell. Appeal rights discussed and explained.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting during business hours will result in civil penalty of $100.00 dollars.
SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5