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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197418290
Report Date: 09/02/2021
Date Signed: 09/08/2021 03:05:27 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
05/12/2021 and conducted by Evaluator Adrian Risher
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210512103224
FACILITY NAME:PALACIO FAMILY CHILD CAREFACILITY NUMBER:
197418290
ADMINISTRATOR:PALACIO DARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 696-9208
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:14CENSUS: 6DATE:
09/02/2021
UNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Darla Palacio LicenseeTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights
Uncleared adult residing in the child day care home
Licensee does not provide adequate supervision to day care children.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/02/2021 at 2:20pm, Licensing Program Analyst (LPA) Adrian Risher, conducted a subsequent complaint visit regarding the above-mentioned allegations and to deliver the findings . Upon arrival, LPA met with Darla Palacio, Licensee. LPA explained the purpose of the inspection. LPA toured the facility with Darla Palacio and observed 6 children.

On 05/12/2021, El Segundo Child Care Regional Office received a complaint regarding a possible personal rights violation. This case was referred to IB to conduct the investigation based on the allegations.
On 05/17/2021, IB Investigator conducted the 10 day visit and interviewed the Licensee.
On 08/16/2021, El Segundo Regional Office received the completed investigation report and based on evidence received during the investigation which included interviews, records and observations, the allegation of personal rights, uncleared adult and lack of care & supervision violations has been found to be unsubstantiated. There is not a preponderance of evidence to prove or disprove the above allegations
Exit interview was conducted and a copy of the report was provided.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
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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