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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419688
Report Date: 07/27/2023
Date Signed: 07/27/2023 12:38:23 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
05/19/2023 and conducted by Evaluator Laticia S Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230519155927
FACILITY NAME:AUSTIN FAMILY CHILD CAREFACILITY NUMBER:
197419688
ADMINISTRATOR:AUSTIN, LATIESHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 333-4647
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY:14CENSUS: DATE:
07/27/2023
UNANNOUNCEDTIME BEGAN:
11:36 AM
MET WITH:Rachelle Bellack, AssistantTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Provider does not ensure clean, safe accomodations to children in care
INVESTIGATION FINDINGS:
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On 07/27/23 at 11:37 AM, Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced site visit for the purpose of delivering findings for complaint allegations received on 05/19/23, associated to complaint control number 58-CC-20230519155927. LPA met with Raychelle Bellack and explained the purpose of the visit. During today’s visit, there were 2 adults providing care and supervision to 8 children in care.

LPA Laticia Thompson is delivering complaint findings for complaint investigations conducted by LPA Antonio Almanza. During the course of the investigation, LPA Almanza conducted interviews with four staff and the Reporting Party; and received a copy of a voicemail and photographs regarding the aforementioned allegations.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
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 58-CC-20230519155927
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 197419688
VISIT DATE: 07/27/2023
NARRATIVE
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The Parent (P1) of Child 1 (C1) disclosed that on 05/19/23 while P1 was on their way home, P1 was going to give C1 a bottle that was given to P1 by Staff 3 (S3) when P1 noticed that the inside of the bottle was covered in mildew; it was “cakey, yellow and smelled sour.”

P1 immediately turned around and went back to the facility and questioned Staff 2 & 3 (S2 & S3). P1 was contacted by Staff 4 (S4), who apologized and told P1 that the bottle must have been left out for a couple hours.

According to S2, P1 came back 5 minutes after picking up C1, showed S2 and S3 the top of the bottle and told them that it was “gross” and asked why it was so dirty. S2 disclosed that they do not deal with bottles and could not explain what happened, and that the bottle was possibly left outside for one or two hours. S3 disclosed that when P1 picked up C1, S3 gave P1 the bottle that was on a chair. S3 disclosed that it had been no more than one hour since the bottle was prepared but did not check the bottle and does not know if the milk was spoiled. S4 became aware that S3 left a bottle outside on the playground for “no longer than 3 hours” and gave the bottle to the parent during pick up. S4 told S3 that the bottle should have been cleaned and they should have given P1 a new bottle.

LPA Almanza received a copy of a voicemail from S2 to P1. S2 apologizes and notifies P1 that they did not know what happened; that S3 washes the bottles, S2 does not handle bottles, and does not know what happened. LPA Almanza received photographs of the bottle and it appears to have a yellow cakey build up at the top.

After considering the information provided, it was revealed that facility staff are unaware of when the bottle was prepared, if the bottle was clean, or if the milk was spoiled, which is in violation of California Code of Regulations, Title 22, Division 12, Chapter 1, section 102423 Personal Rights.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 58-CC-20230519155927
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 197419688
VISIT DATE: 07/27/2023
NARRATIVE
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Based on interviews which were conducted, and documentation provided, the preponderance of evidence standard has been met; therefore, the above allegations are found to be substantiated. California code of Regulations, Title 22, Division 12, Chapter 1, section 102423 Personal Rights is being cited on the attached LIC9099D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Raychelle Bellack, Assistant.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 58-CC-20230519155927
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 197419688
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/27/2023
Section Cited
CCR
102423(a)(2)
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Personal Rights, To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.: This requirement is not met as evidenced by:
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Facility will create a bottle log, feeding log an a cleaning log. Licesee will provide proof of logs by 07/31/2023.
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Based on interviews conducted, during pick up, staff provided P1 with a yellow, cakey, dirty bottle, which poses a potential Health or Safety, or Personal Rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4