153910248-2-2-2022-04-CC-DMAA-CBAW4J-20220203155736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 153910248
Report Date: 02/02/2022
Date Signed: 02/02/2022 01:01:37 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2021 and conducted by Evaluator Norma Lomeli

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20211104154502

FACILITY NAME:	FORD, SHANITA FAMILY CHILD CARE		FACILITY NUMBER:	153910248
ADMINISTRATOR:	FORD, SHANITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 670-4031
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93309
CAPACITY:	14	CENSUS: 3	DATE:	02/02/2022
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Shanita Ford		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not provide adequate supervision resulting in day care child sustaining an injury.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA), Norma Lomeli arrived at facility to conduct an unannounced complaint inspection to close complaint for the above mentioned allegation. Met with Licensee, Shanita Ford and census was taken. During the investigation, witnesses revealed that during the incident that occurred on 10/26/21 resulting in a day care child sustaining an injury; there were two qualified assistants and eight children in care. Licensee was not at the facility when the incident occurred. It was revealed that the two assistants were in the kitchen while the eight day care children were in the living room when the incident occurred. The living room is adjacent to the kitchen and there is a cabinet kitchen island that separates the two rooms. The two assistants revealed that they were both in the kitchen when the incident occurred and did not witness the incident because it happened so fast. Licensee states that she will ensure that licensee or one of her assistants has direct care and supervision of the day care children at all times to prevent future incidents that may result in an injury.

(Continued on LIC9099-C):

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

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 2

Control Number 04-CC-20211104154502

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FORD, SHANITA FAMILY CHILD CARE	FACILITY NUMBER: 153910248
	VISIT DATE: 02/02/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore the allegation is UNSUBSTANTIATED.

As of January 1, 2017, the term “inconclusive” is no longer used to refer to the outcome of certain complaint investigations. Such complaint allegations are now deemed “unsubstantiated.” This document has not yet been updated to reflect this change and for purposes of this complaint investigation the Department’s finding is that this allegation was unsubstantiated.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency is cited during today's visit.

An exit interview conducted with Licensee, Shanita Ford. A copy of this report and Appeal Rights were provided and discussed with Ms. Ford.

LPA observed licensee post the Notice of Site Visit Form on parent's board and understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2