197418793-2-23-2022-30-CC-CESO-CCEPNB-20220311102737

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197418793
Report Date: 02/23/2022
Date Signed: 02/23/2022 01:54:56 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
01/21/2022 and conducted by Evaluator Lisa Rios

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20220121114100

FACILITY NAME:	PEREZ FAMILY CHILD CARE		FACILITY NUMBER:	197418793
ADMINISTRATOR:	PEREZ, LILIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 384-3108
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	12	CENSUS: 7	DATE:	02/23/2022
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Licensee Lila Perez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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License-
Licensee did not inform parent of child's illness
Personal Rights-
Hazards accessible to children in care

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Lisa Rios made an unannounced inspection to the Perez Family Child Care on 2/23/22 for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rios met with Licensee, Lila Perez and together discussed the investigation details.

Based on the interviews conducted during the investigation process and statements obtained during the investigation process, the allegations cannot be substantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies will be cited at this time.

Exit interview was conducted with the Licensee

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

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

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
01/21/2022 and conducted by Evaluator Lisa Rios

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20220121114100

FACILITY NAME:	PEREZ FAMILY CHILD CARE		FACILITY NUMBER:	197418793
ADMINISTRATOR:	PEREZ, LILIA		FACILITY TYPE:	810
ADDRESS:	3819 KEYSTONE AVE.		TELEPHONE:	(310) 384-3108
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	12	CENSUS:	DATE:	02/23/2022
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Licensee Lila Perez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Neglect/Lack of Supervision-
Licensee did not provide appropriate supervision to child in care

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Lisa Rios made an unannounced inspection to the Perez Family Child Care on 2/22/22 for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rios met with Licensee, Lila Perez and together discussed the investigation details.
Based on the observations made by LPA Rios, on 1/26/22 the licensee brought a child in the home to feed in a highchair in the back of the living room while remaining four children were left in the front yard playing. Although the front yard is enclosed by a fence, licensee has a limited view of the front yard and cannot observe the entire space. LPA Rios said something regarding the children left outside alone and the licensee stated that she left the door open so she could watch them. LPA Rios stated that this was not adequate supervision and asked the licensee to either bring the children inside while the child ate or have her eat outside. The licensee then carried the child outside. The Department has concluded, based on the preponderance of the evidence obtained during this investigation, that the allegation of Licensee did not provide appropriate supervision to child in care, is SUBSTANTIATED.
The following Type A deficiency is being cited per California Code of Regulations, TITLE 22, DIVISION 12, CHAPTER 1 Articles 1-7, 102417(a).

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

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 4

Control Number 30-CC-20220121114100

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: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 197418793
	VISIT DATE: 02/23/2022

NARRATIVE

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LPA Lisa Rios informed licensee Lila Perez that this report dated 2/23/22 documents 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Lisa Rios informed the licensee Lila Perez to provide a copy of this licensing report dated 2/23/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 30-CC-20220121114100

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: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 197418793
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/23/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/23/2022 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	102417 Operation of a Family Child Care Home (a)The licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement is not met as evidenced by, based on observation during facility visit, LPA Rios witnessed the licensee come inside to feed a child in a high	1 2 3 4 5 6 7	Licensee will submit to the department a statement declaring that when she needs to accompany a child inside and the children are outside playing, that she will make sure the children go with her, no later than 3/23/22 by email at lisa.rios@dss.ca.gov.
	8 9 10 11 12 13 14	chair at the back of the living room while 4 children stayed outside playing. LPA Rios asked the licensee to take the high chair outside to feed the child so other chidlren could be supervised.	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: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4