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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198021030
Report Date: 11/10/2022
Date Signed: 11/10/2022 04:37:03 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, 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
11/08/2022 and conducted by Evaluator Carolyn Tuba
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20221108160643
FACILITY NAME:FUTURE LEADERS SCHOOLFACILITY NUMBER:
198021030
ADMINISTRATOR:BERTHA GIRGISFACILITY TYPE:
840
ADDRESS:1172 E. CYPRESS STTELEPHONE:
(562) 417-0802
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY:42CENSUS: 0DATE:
11/10/2022
UNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Bertha GirgisTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff transporting day-care children in an unsafe manner.
INVESTIGATION FINDINGS:
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On 11/10/2022 at 09:05 a.m., Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced complaint inspection to deliver findings of the above allegations. A Covid risk assessment was conducted when entering the facility. LPA met with Director/Owner, Bertha Girgis, who guided LPA on a tour of the facility. There was a total of 0 children present with 0 staff.
Complainant alleged that Staff Transporting Day-Care children in an unsafe manner. Based on the Director’s own admission on 11/04/2022, LPA Carolyn Tuba clarified California Code Title 22 section 101225(b), which states that the manufacturer's rated seating capacity of the vehicles shall not be exceeded. Based on interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation at this time is found to be substantiated. The California Code of Regulations, (Title 22, Division & Chapter) relating to this allegation have been cited on LIC 9099-D.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
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 33-CC-20221108160643
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: FUTURE LEADERS SCHOOL
FACILITY NUMBER: 198021030
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/10/2022
Section Cited
CCR
101225(b)
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101225(b)The manufacturer's rated seating capacity of the vehicles shall not be exceeded.

This requirement is not met as evidenced by:
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LPA provided consultation and discussed protocols that can be followed. Director has ensured that these practices will be in place to
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Based on Directors admission of incident that occurred on 10/27/2022 where 12 children were transported when van only accomdates 11 children.
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ensure the safety when transporting children.
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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: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20221108160643
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: FUTURE LEADERS SCHOOL
FACILITY NUMBER: 198021030
VISIT DATE: 11/10/2022
NARRATIVE
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LPA informed facility Director/Owner that this report dated 11/10/2022 document(s) (1) Type A citation(s), which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

LPA informed the Director/Owner to provide a copy of this licensing report dated 11/10/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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. Exit interview was conducted with Director, Bertha Girgis.
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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3