065406060-3-16-2022-13-CC-MAVS-CCLQFG-20220317120753

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 065406060
Report Date: 03/15/2022
Date Signed: 03/16/2022 04:43:51 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2022 and conducted by Evaluator Laura Chavez

PUBLIC

COMPLAINT CONTROL NUMBER: 13-CC-20220222152522

FACILITY NAME:	RIVERA, ANGELICA FAMILY CHILD CARE HOME		FACILITY NUMBER:	065406060
ADMINISTRATOR:	RIVERA, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 473-2168
CITY:	WILLIAMS	STATE: CA	ZIP CODE:	95987
CAPACITY:	14	CENSUS: 8	DATE:	03/15/2022
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Angelica Rivera		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Licensee operating over capacity

INVESTIGATION FINDINGS:

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On 3/22/2021 at 11:15am, Licensing Program Analyst (LPA) Laura Chavez conducted an unannounced follow-up complaint inspection to the facility and met with Licensee Angelica Rivera. It has been alleged that the licensee is operating over capacity, specifically on 1/15/2022 and 1/22/2022. Licensee denied the allegation and stated that in January 2022, C1, C2, and C3 typically left day-care at 1:30 pm as C4, C5, and C6 arrived at day-care and may have looked as though there were more children in care than her capacity allows.

A review made on 3/10/2022 by LPA Laura Chavez of meal attendance sheets submitted by Licensee Angelica Rivera to Colusa County Children's Services, Food Program for January 2022 certifying days and hours of children in attendance revealed that 15 children, C1 thru C-15 were present on January 15, 2022, between 6:20am - 8:00am and 15 children, C-1 thru C-15 were present on January 22, 2022, between 6:21am – 8:00am.

Report continued: See LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 13-CC-20220222152522

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: RIVERA, ANGELICA FAMILY CHILD CARE HOME	FACILITY NUMBER: 065406060
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/15/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/15/2022 Section Cited CCR 102416.5(f)	1 2 3 4 5 6 7	Staffing Ratio and Capacity: The total licensed capacity for a Large Family Child Care Home shall not exceed 14 children. This requirement was not met as evidenced by a review of meal attendance sheets submitted by the licensee indicating 15 children were in care at one time on 1/15/2022 and 1/22/2022.	1 2 3 4 5 6 7	The licensee agrees to submit a written statement on how she will ensure that she will not operate over capacity. The plan of correction shall be submitted to CCLD on or before 4/15/2022.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

LIC9099 (FAS) - (06/04)

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Control Number 13-CC-20220222152522

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: RIVERA, ANGELICA FAMILY CHILD CARE HOME	FACILITY NUMBER: 065406060
	VISIT DATE: 03/15/2022

NARRATIVE

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During today’s visit the facility was toured at 11:25am. LPA observed the licensee and her assistant caring for 8 children.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, 102416.5(f), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

LIC9099 (FAS) - (06/04)

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