197403589-10-14-2019-12-CC-CBEL-BH6TWE-20191021150525

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197403589
Report Date: 10/14/2019
Date Signed: 10/14/2019 04:32:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/07/2019 and conducted by Evaluator Tyicee Lawson

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20190807091925

FACILITY NAME:	REINA FAMILY DAY CARE		FACILITY NUMBER:	197403589
ADMINISTRATOR:	CECILIA REINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 831-0585
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91326
CAPACITY:	14	CENSUS: 1	DATE:	10/14/2019
		UNANNOUNCED	TIME BEGAN:	02:28 PM
MET WITH:	Cecilia Reina		TIME COMPLETED:	04:48 PM

ALLEGATION(S):

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Operation of a Family Child Care Home - Licensee failed to supervise children in care, resulting in Child #1 inflicting injuries on Child #2.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Lawson and Sims conducted an unannounced Complaint Investigation about the above allegation. Licensee facilitated a tour of the facility. Present upon arrival were Licensee, Assistant and one child.

During this inspection LPAs conducted a records review and interviewed staff. The investigation revealed that on 06/27/2019, during nap time, Licensee was absent from the home. Children were left in the care of a qualified assistant. During nap time Child #1 exited the playpen and scratched Child #2's face and bit Child #2's body.

Based on the evidence obtained through interviews and records reviewed the preponderance of evidence has been met; therefore, the above allegation is Substantiated.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019

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 12-CC-20190807091925

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: REINA FAMILY DAY CARE	FACILITY NUMBER: 197403589
	VISIT DATE: 10/14/2019

NARRATIVE

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Facility was cited Type A deficiency. Please see Complaint Investigation Report LIC 9099-D for deficiency cited.

Upon receipt of this report, the report must be posted along with the Notice of Site visit for 30 days for parents to view. Facility must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC 9224 Acknowledgement of Receipt of Licensing Reports.

An exit interview was conducted with the Licensee, Cecilia Reina, and a copy of this report was provided along with the appeal rights.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019

LIC9099 (FAS) - (06/04)

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Control Number 12-CC-20190807091925

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: REINA FAMILY DAY CARE	FACILITY NUMBER: 197403589
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/14/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/15/2019 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	102417 Operation...Family Child Care Home: (a)The licensee ... shall ensure that children in care are supervised at all times. When...absent from the home, the licensee shall arrange...care for and supervise the children. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Effective immediately Licensee shall ensure children in care are supervised at all times to prevent this type of incident from reoccurring. Licensee shall submit a Plan of Correction to the department no later than 10/15/2019. The Plan of Correction shall outline how Licensee will ensure that
	8 9 10 11 12 13 14	Based on interviews and records reviewed, Licensee failed to provide adequate supervision which resulted in Child #1 inflicting scratches on Child #2's face and biting Child #2's body, which presents an immediate risk to health and safety of children in care.	8 9 10 11 12 13 14	children in care will be provided supervision at all times, especially during nap time.
	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: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019

LIC9099 (FAS) - (06/04)

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