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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 192010570
Report Date: 09/24/2021
Date Signed: 09/26/2021 09:32:48 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
09/17/2021 and conducted by Evaluator Veronica Wheatley
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210917141548
FACILITY NAME:JACKSON FAMILY CHILD CAREFACILITY NUMBER:
192010570
ADMINISTRATOR:JACKSON, JACQUELINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 819-8325
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY:14CENSUS: 3DATE:
09/24/2021
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jacqueline JacksonTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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On September 24, 2021, Licensing Program Analyst (LPA), V. Wheatley conducted an unannounced inspection regarding the above allegation. LPA met with the licensee Jacqueline Jackson and observed three (3) day care children napping. The children were supervised properly. LPA interviewed the licensee and assistant Staff #1.

LPA interivewed the licensee who stated that the anti bacterial spray was being used on clothes to prevent Covid-19. Licensee states she has underlining health conditions and is using the spray, hand sanitizer and disinfecting wipes to prevent Covid-19. Licensee and witness state the parents voluntarily spray the children's clothes and is not sprayed in their eyes or on their skin. Licensee states she stayed open during the Pandemic to help families in the community. Licensee states she took a risk to open her home to serve essential workers and other parents.

Based on interviews, the allegation is substantiated which means that the allegation is valid because the preponderance of the evidence standard has been met.

Exit interview. Copy of this report will be emailed to the licensee.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
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 2
Control Number 30-CC-20210917141548
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: JACKSON FAMILY CHILD CARE
FACILITY NUMBER: 192010570
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2021
Section Cited
CCR
102423(a)(2)
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102423(a)(2)-Personal Rights
Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.


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Licensee will cease allowing the parents from using spray on the children's clothing. The parents will be informed. The licensee will submit a written plan to the Department by September 27, 2021 that she will cease using the spray.
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Licensee was allowing parents to spray antibacterial spray on children's clothing to prevent Covid-19. Based on interviews which were conducted a personal rights violation is being cited. This poses a potential risk to the health, safety, or personal rights risk to 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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
LIC9099 (FAS) - (06/04)
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