197414219-10-28-2021-12-CC-MRAN-C8VNZT-20211118095451

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197414219
Report Date: 10/28/2021
Date Signed: 10/28/2021 09:43:45 PM

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

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: 6	DATE:	10/28/2021
		UNANNOUNCED	TIME BEGAN:	07:36 PM
MET WITH:	Gwendolyn Roberts, Licensee		TIME COMPLETED:	10:14 PM

ALLEGATION(S):

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Personal Rights: Staff Camille McGhee mistreat and itimadate child #13 in care

INVESTIGATION FINDINGS:

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On October 28, 2021, Licensing Program Analyst (LPA) Lady King-Lewis, Licensing Program Managers (LPMs), Mariela Ramon, and Carissa Bell conducted a complaint investigation inspection for the purpose to investigate the above allegation. Upon arrival, LPA and LPMs met with licensee's assstance who was providing care to 4 school age children and 2 infants during this inspection.

LPA and LPMs toured the facility of the day care areas. The investigation of the above allegation consisted of intervews with staff, licensee and additional evidence obtained by the Department. The Department obtained evidence that revealed that on one occasion, licensee's assistant spoke to child #13. in a loud and aggressive manner because child #13 had flooaded the bathroom. Licensee’s assistant intimidated child #13 by telling child #13, "licensee going to come in here with fire. “Oh so you wanna ignore? That's what we doing? Don't trip.

Please see Complaint investigation Report LIC 9099C for additional information.

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: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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 4

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: 10/28/2021

NARRATIVE

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You better hope I'm still at my doctor’s appointment." Licensee's assistant admitted to speaking to child #13 in this manner.

Based on the information obtained and licensee's assistant own admission to the allegation, the allegation is deemed to be 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 currently/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: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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: 10/28/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/29/2021 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 that revealed that on one licensee's assistant	1 2 3 4 5 6 7	The Department has served the licensee a Temporary Suspension Order.
	8 9 10 11 12 13 14	Camille McGhee spoke to child #13 in a loud and aggressive manner because child #13 had flooaded the bathroom. Licensee’s assistant intimidated child #13 by telling child #13, "licensee going to come in here with fire. “Oh so you wanna ignore? That's what we doing? Don't trip". 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
	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: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

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: 6	DATE:	10/28/2021
		UNANNOUNCED	TIME BEGAN:	07:36 PM
MET WITH:	Gwendolyn Roberts, Licensee		TIME COMPLETED:	10:14 PM

ALLEGATION(S):

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Operation a Family Child Care Home: Facility is dirty

INVESTIGATION FINDINGS:

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On October 28, 2021, Licensing Program Analyst (LPA) Lady King-Lewis, Licensing Program Managers (LPMs), Mariela Ramon, and Carissa Bell conducted a complaint investigation inspection for the purpose to investigate the above allegation. Upon arrival, LPA and LPMs met with licensee's assstance who was providing care to 4 school age children and 2 infants during this inspection.

LPA and LPM toured the area of the day care facility on 10-26-21 and 10-28-21 and observed the facility daycare areas to be kept clean and orderly.

Based on LPA and LPMs observation the above allegation has 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.

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: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 4