197415094-1-16-2020-30-CC-MRUZ-BLGUY7-20200204145928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197415094
Report Date: 01/16/2020
Date Signed: 01/16/2020 12:50:36 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
01/14/2020 and conducted by Evaluator Keyona Scott

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20200114134046

FACILITY NAME:	CHAPPELL FAMILY CHILD CARE		FACILITY NUMBER:	197415094
ADMINISTRATOR:	CHAPPELL, RAYSHAUN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 973-8064
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS: 5	DATE:	01/16/2020
		UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Rayshaun Chappell		TIME COMPLETED:	01:05 PM

ALLEGATION(S):

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LICENSE: Facility operating over capacity

OTHER: Uncleared adult residing in home

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs), Keyona Scott and Shandra Powell, conducted an unannounced inspection to the family child care home, on 01/16/2020, for the purpose of conducting a complaint investigation. LPAs met with Licensee, Rayshaun Chappell. LPA Scott was guided on a tour inside and outside of the home at 8:20 AM. Present during the inspection, was Licensee, Licensee's Assistant (Adult 1) and three staff (Adult 2, Adult 3, Adult 4) and five children, which includes one infant. All Adults present, working and residing in the home are fingerprint cleared and associated to the facility.

During the inspection, LPAs conducted interviews and obtained the following: Child Care Facility Roster (LIC 9040)

LPA conducted observation and interviews and obtained information, regarding alleagtions made against the Family Child Care Home. It was alleged that the facility has had 18 children in care and that there is an uncleared Adult residing in the home. Page 1

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

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 30-CC-20200114134046

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: CHAPPELL FAMILY CHILD CARE	FACILITY NUMBER: 197415094
	VISIT DATE: 01/16/2020

NARRATIVE

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During the inspection, LPAs attempted to conduct interviews with three children in care; however, two of the children did not qualify. Child 3 was able to verify the staff that provide care; however, did not know the referenced uncleared Adult.

LPAs contacted four parents from the Child Care Facility Roster, however, was only able to speak with one Parent. Parent 2 stated that she does not know the referenced uncleared Adult and does not know staff names outside of Licensee and Licensee's Assistant.

LPAs also conducted interviews with the three staff present as well as the Licensee. During the interviews conducted, there were no disclosures made regarding the facility being over capacity. Each staff stated there has not been more than five to twelve children present at a time. Each staff along with Licensee is unaware of aforementioned uncleared Adult residing or being present in the home. Staff and Licensee did not know uncleared Adult.

Based on facility observation, interviews conducted and information obtained, the allegations of LICENSE, facility operating over capacity and OTHER, uncleared adult residing in the home, are UNSUBSTANTIATED, meaning although the allegations may have happened or are valid, the preponderance of the evidence standard has not been met.

Licensee was provided the following safe sleep practices: always place infants on their backs for sleeping; use only a tight-fitting sheet on the crib or play yard mattress; do not hang any items from the crib or above the crib; keep all items, including blankets, out of the crib or play yard; pacifiers may be used as long as they do not have items attached to them; infants should not be swaddled or have any items covering them while sleeping; the temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold. Please note, these guidelines are recommendations for best practices only, until regulations are approved and adopted.

Licensee was provided the following form/brochure:
SafeBaby2indd- Safe Sleep

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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 30-CC-20200114134046

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: CHAPPELL FAMILY CHILD CARE	FACILITY NUMBER: 197415094
	VISIT DATE: 01/16/2020

NARRATIVE

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The Licensee was advised that, once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.

No deficiencies were cited during this inspection on 01/16/2020.

A copy of this report, Advisory Note (LIC 9102), Notice of Site Visit and Appeal Rights were provided to Licensee, Rayshaun Chappell, whose signature confirms today's report and inspection.

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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

LIC9099 (FAS) - (06/04)

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