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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191805170
Report Date: 05/21/2021
Date Signed: 05/21/2021 03:33:14 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2021 and conducted by Evaluator Shandra Powell
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210312093453
FACILITY NAME:FREEMAN FAMILY CHILD CAREFACILITY NUMBER:
191805170
ADMINISTRATOR:FREEMAN, LISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 754-8049
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:14CENSUS: 1DATE:
05/21/2021
UNANNOUNCEDTIME BEGAN:
03:09 PM
MET WITH:Lisa Freeman, LicenseeTIME COMPLETED:
03:25 PM
ALLEGATION(S):
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Lack of Supervision - Licensee left day care children unattended.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shandra Powell conducted a complaint inspection on 05/21/2021. Due to COVID-19 and precautionary measures this inspection was conducted via Tele-visit procedures. The purpose of the tele-inspection was to deliver the findings for the above allegation. LPA met with Lisa Freeman, Licensee, one child present during the inspection.

During the course of the investigation interviews were conducted and documentation was collected. Disclosures were made during interviews that children are unattended while licensee is preparing food for children and while licensee goes to the upstairs area of the home.

Based on the information obtained during the investigation the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.



Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2021 and conducted by Evaluator Shandra Powell
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210312093453

FACILITY NAME:FREEMAN FAMILY CHILD CAREFACILITY NUMBER:
191805170
ADMINISTRATOR:FREEMAN, LISAFACILITY TYPE:
810
ADDRESS:836 W. 92ND ST.TELEPHONE:
(323) 754-8049
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:14CENSUS: 1DATE:
05/21/2021
UNANNOUNCEDTIME BEGAN:
03:09 PM
MET WITH:Lisa Freeman, LicenseeTIME COMPLETED:
03:25 PM
ALLEGATION(S):
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Personal Rights;
Licensee handles day care child(ren) in a rough manner
Licensee force fed day care child.
Licensee deprived day care child of food
Licensee not providing safe/comfortable environment for sleeping infant(s)
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shandra Powell conducted a complaint inspection on 05/21/2021. Due to COVID-19 and precautionary measures this inspection was conducted via Tele-Inspection procedures. The purpose of the tele-inspection was to deliver the findings for the above allegations. LPA met with Lisa Freeman, Licensee, there was one child present during the inspection.


Based on the investigation and interviews conducted, there were no disclosures for the above allegations; therefore, the allegations of PERSONAL RIGHTS, licensee handles daycare child(ren) in a rough manner, licensee force fed daycare child, licensee deprived daycare child of food and licensee not providing safe/comfortable environment for sleeping infant(s), is UNSUBSTANTIATED, meaning although the allegation may have happened or is valid, the preponderance of the evidence standard has not been met.




Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 30-CC-20210312093453
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FREEMAN FAMILY CHILD CARE
FACILITY NUMBER: 191805170
VISIT DATE: 05/21/2021
NARRATIVE
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Safe sleep for your baby pamphlet and what does safe sleep look like wall flyer provided to applicant via U.S. mail. LPA also requested licensee and assistant to read and refer to Title 22, Division 12 Chapter 1 Article 06. 10245 Infant Safe Sleep.

Due to COVID-19 and precautionary measures, an exit phone interview was conducted with Lisa Freeman, licensee and a copy of this report was signed by LPA Shandra Powell. This report will be sent via email to licensee who agrees to sign and date the report. The Licensee was provided with the mailing address of the El Segundo Regional office and agrees to send a signed copy of this report by mail. A copy of the appeal rights (LIC9058 01/16) were also provided.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 30-CC-20210312093453
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FREEMAN FAMILY CHILD CARE
FACILITY NUMBER: 191805170
VISIT DATE: 05/21/2021
NARRATIVE
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A finding of Substantiated means that the allegation has been found to be valid because the preponderance of the evidence standard has been met. Based on information obtained during this investigation, California Code of Regulation, 102417(a) Operations of a Child Care Home, is being cited on the attached LIC 9099D.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

Due to COVID-19 and precautionary measures, an exit phone interview was conducted with Lisa Freeman, licensee and a copy of this report was signed by LPA Shandra Powell. This report will be sent via email to licensee who agrees to sign and date the report. The Licensee was provided with the mailing address of the El Segundo Regional office and agrees to send a signed copy of this report by mail. A copy of the appeal rights (LIC9058 01/16) were also provided.

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 30-CC-20210312093453
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FREEMAN FAMILY CHILD CARE
FACILITY NUMBER: 191805170
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/26/2021
Section Cited
CCR
102417(a)
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Operations of a Family Child Care Home:
(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times... The requirement is not met as evidenced by licensee confirming Children are left alone while meals are prepared and
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Licensee will complete a Declaration Form LIC 855 stating no children will be unsupervised at anytime during child care hours. Licensee will send Declaration Form with original signature to LPA to Regional Office by POC date 05/26/2021.
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disclosures were made that licensee leaves children alone while she goes into another part of the home. This poses an immediate risk to the health and safety of children in care.
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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.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5