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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197403943
Report Date: 09/03/2019
Date Signed: 09/03/2019 01:03:59 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
06/10/2019 and conducted by Evaluator Linda Thompson-Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20190610112210
FACILITY NAME:GODINEZ FAMILY DAY CAREFACILITY NUMBER:
197403943
ADMINISTRATOR:CLORICE A. GODINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 365-5911
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY:14CENSUS: 5DATE:
09/03/2019
UNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:Clorice A. GodinezTIME COMPLETED:
01:18 PM
ALLEGATION(S):
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Allegation #1: Personal Rights--Licensee engaged in a verbal altercation in the presence of children
INVESTIGATION FINDINGS:
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Licensing Program Analyst's (LPAs) Thompson-Miller and Sims conducted an unannounced complaint inspection for the purpose of delivering finding for the above allegation. Upon arrival LPAs observed five children (four preschool/toddler, one infant) in care along with licensee and licensee assistant. LPAs met with Licensee, Clorice A. Godinez. Interviews conducted with licensee, staff and other relevant complaint parties revealed a child witnessed and heard the altercation between Licensee and a Parent. Child disclosed that the licensee’s and parent’s voices were used in a loud manner. Based on the evidence obtained It is determined that Licensee and a Parent engaged in a verbal altercation in the presence of children. Licensee did not use good judgement in handling the situation by allowing the conversation to escalate resulting in the violation of personal rights. The above allegation is Substantiated. LIC9099D issued.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019
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-20190610112210
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: GODINEZ FAMILY DAY CARE
FACILITY NUMBER: 197403943
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
10/03/2019
Section Cited
CCR
102423
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(1)To be treated with dignity in his/her personal relationship with staff and other persons.
This requirement was not met as evidenced by: Interviews conducted indicated that licensee
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Speak in an indoor voice.
Licensee shall review CCLD Child Care Video on Personal Rights and submit written report documenting how licensee will protect children’s rights while in care and submit to CCL by due date.
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engaged in a verbal altercation in the presence of children resulting in a personal rights violation.
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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: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019
LIC9099 (FAS) - (06/04)
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