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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419908
Report Date: 10/03/2019
Date Signed: 10/03/2019 05:03:27 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/30/2019 and conducted by Evaluator Denise Gibbs
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20190830130505
FACILITY NAME:HALL FAMILY CHILD CAREFACILITY NUMBER:
197419908
ADMINISTRATOR:HALL, CUPIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 816-4752
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY:14CENSUS: DATE:
10/03/2019
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Cupid Hall, LicenseeTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Child was choked while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced complaint inspection to the above facility. LPA met with Cupid HAll, Licensee, who guided analysts on a tour of the facility. Also present during the inspection was Crystal Hamilton. There were 6 children present upon arrival. (4 daycare, 2 grandchildren).

During the investigation LPA obtained a copy of the facility roster, interviewed children and adults.

Information provided by the reporting party indicates adult choked child while in care.

Licensee states that she was out picking up school age children and did not witness the above allegation. Licensee stated she was told of the incident after the fact by both parties.

Adult#2 interviewed discosed that adult #1 touched child #1's shoulders in order to redirect behavior ---PAGE 1


Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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 2
Control Number 54-CC-20190830130505
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HALL FAMILY CHILD CARE
FACILITY NUMBER: 197419908
VISIT DATE: 10/03/2019
NARRATIVE
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Child #2 stated that adult#1 put hands on Child #1's shoulders "without force" to sit him down. Child #2 stated that adult #1 did not touch Child #1.

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.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview conducted with Cupid Hall, Licensee. Appeal Rights explained and provided to the licensee during this visit.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2