197414219-10-27-2021-12-CC-MRAN-C8VNZU-20211118095452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197414219
Report Date: 10/26/2021
Date Signed: 10/27/2021 07:18:52 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2021 and conducted by Evaluator Lady King

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20211021103255

FACILITY NAME:	ROBERTS FAMILY CHILD CARE		FACILITY NUMBER:	197414219
ADMINISTRATOR:	ROBERTS, GWENDOLYN J.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 400-9912
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	14	CENSUS: 9	DATE:	10/26/2021
		UNANNOUNCED	TIME BEGAN:	04:43 PM
MET WITH:	Gwendolyn Joyce Roberts, Licensee		TIME COMPLETED:	09:44 PM

ALLEGATION(S):

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Personal Rights: Staff yell at day care children

Personal Rights: Licensee called child #1 a derogatory racial remark, “Nigga.”

INVESTIGATION FINDINGS:

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On October 26, 2021, Licensing Program Analyst (LPA) Lady King-Lewis and Licensing Program Manager (LPM), Mariela Ramon, conducted a complaint investigation inspection for the purpose to investigate the above allegations. Upon arrival, LPA and LPM met with licensee who was providing care to 8 school age children and 1 infant with the assistance of 3 staff members.

LPA and LPM toured the facility and obtained photographs of the day care areas including a copy of the facility roster.

The investigation of the above allegations consisted of children, staff, and licensee interviews including LPA and LPM observations, and additional evidence obtained. The investiagtion revealed that on July 2021, licensee called child #1 "Nigga". Licensee stated she did not use the word in a derogative manner, LPA obtained information that Licensee and Staff # 1 yell at the children in care. please see Complaint investigation report 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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

Control Number 12-CC-20211021103255

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBERTS FAMILY CHILD CARE	FACILITY NUMBER: 197414219
	VISIT DATE: 10/26/2021

NARRATIVE

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Based on the evidence obtained, the allegations of staff yell at day care children and Licensee called child #1 a derogatory racial remark, “Nigga.”are substantiated.

Facility was cited Type A deficiencies. Please see Complaint Investigation Report LIC 9099D for citations.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. When a Type A deficiency is cited, the report must be provided to parent/guardians of children newly enrolled at the facility during the next 12 months and licensee must obtain a signed Acknowledgment of Licensing Reports (LIC 9224) from parents and guardians place in each child's file. If these requirements are not met, civil penalties per violation will be assessed.

An exit interview was conducted, a copy of this report was read and provided to the licensee along with the appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

LIC9099 (FAS) - (06/04)

Page: 4 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2021 and conducted by Evaluator Lady King

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20211021103255

FACILITY NAME:	ROBERTS FAMILY CHILD CARE		FACILITY NUMBER:	197414219
ADMINISTRATOR:	ROBERTS, GWENDOLYN J.		FACILITY TYPE:	810
ADDRESS:	43834 GADSDEN AVENUE		TELEPHONE:	(661) 400-9912
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	14	CENSUS: 9	DATE:	10/26/2021
		ANNOUNCED	TIME BEGAN:	04:43 PM
MET WITH:	Gwendolyn Joyce Roberts, Liensee ,		TIME COMPLETED:	09:44 PM

ALLEGATION(S):

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Personal Rights: Staff make children exercise as a form of discipline.

Personal Rights: Facility is not following proper COVID-19 protocols

Personal Rights: Children are required to ask staff for toilet paper when they go to the restroom

INVESTIGATION FINDINGS:

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On October 26, 2021, Licensing Program Analyst (LPA) Lady King-Lewis and Licensing Program Manager (LPM), Mariela Ramon, conducted a complaint investigation inspection for the purpose to investigate the above allegations. Upon arrival, LPA and LPM met with licensee who was providing care to 8 school age children and 1 infant with the assistance of 3 staff members.

LPA and LPM toured the facility and obtained photographs of the day care areas including a copy of the facility roster. The investigation of the above allegations consisted of children and staff interviews including LPA and LPM observations.

During interviews conducted with child #1, child #2, child #3 and child #4, it was disclosed that they do exercise at the facility. They do jumping jacks, squatts, planks including watching and follwoing children YouTube videos on exercise routines. Please see Complaint Investigation Report LIC 9099C for additional information.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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 12-CC-20211021103255

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBERTS FAMILY CHILD CARE	FACILITY NUMBER: 197414219
	VISIT DATE: 10/26/2021

NARRATIVE

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Interviews with children revealed staff and children wear facility coverings. LPA and LPM observed all day
care children present and staff wearing facial coverings. LPA and LPM observed addtional personal protective equipment available at the facility.

Licensee and staff interviews revealed toilet paper is not available in the bathroom children use to prevent children from putting too much toilet paper in the toilet causing the toilet to clog up. Licensee stated she had this occur multiple times in the past; therefore, staff provide children with toilet paper before they use the bathroom to ensure children do not misuse the toilet paper and make the toilet inoperable.

Based on the evidence obtained, the aforementioned allegations have been deemed to be unsubstantiated.

An exit interview was conducted, a copy of this report was read and provided to the licensee along with the appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 12-CC-20211021103255

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBERTS FAMILY CHILD CARE	FACILITY NUMBER: 197414219
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/26/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/27/2021 Section Cited CCR 102423(a)(1)	1 2 3 4 5 6 7	Personal Rights: These rights include, but are not limited to, the following: To be treated with dignity in his/her personal relationship with staff and other persons. This requirement was not met as evidence by the Department obtained evidence that on July 2021, Licensee yelled at children..	1 2 3 4 5 6 7	Licensee shall submit to the Department a written statement no later than 10/27/21 indicating how she will prevent this type of incident from reoccurring to ensure the personal rights of children are not violated.
	8 9 10 11 12 13 14	This is a Type A violation and it poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14
Type A 10/27/2021 Section Cited CCR 102423(a)(4)	1 2 3 4 5 6 7	Personal Rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to ….This requirement was not met as evidence by the Department has obtained evidence The investiagtion revealed that on July 2021,	1 2 3 4 5 6 7	Licensee shall submit a written statement to the Department no later than 10/27/21 indicating how she will prevent this type of incident from reoccurring to ensure the personal rights of children are not violated.
	8 9 10 11 12 13 14	licensee called child #1 "Nigga". Licensee stated she did not use the word in a derogative manner, This is a Type A violation and it poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14

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: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

LIC9099 (FAS) - (06/04)

Page: 5 of 5