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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419908
Report Date: 02/10/2020
Date Signed: 02/10/2020 05:58:54 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
01/15/2020 and conducted by Evaluator Denise Gibbs
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20200115130727
FACILITY NAME:HALL FAMILY CHILD CAREFACILITY NUMBER:
197419908
ADMINISTRATOR:HALL, CUPIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 819-2445
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY:14CENSUS: 9DATE:
02/10/2020
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Cupid Hall, LicenseeTIME COMPLETED:
06:15 PM
ALLEGATION(S):
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Hazardous items are accessible to children in care
Lack of supervision resulting in child ingesting a hazardous item
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced complaint inspection on 2/10/2020 at 4:00PM to investigate the above allegations. LPA toured facility with licensee, Cupid Hall. Also present during inspection was S2, licensee's assistant and A1. There were 9 present during this visit, 1 child is ten years old.

During the course of this investigation, LPA interviewed licensee, staff, parents, children and documentation was collected. No disclosures were made regarding the above allegations from interviews conducted. During observation on different occasions, LPA observed that the home is clean and orderly and all hazardous items are inaccessible to children in care. During inspection LPA observed that the children in care were being supervised at all times.

Although the allegations may have happened or are valid there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. -------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: 02/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2020
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-20200115130727
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: 02/10/2020
NARRATIVE
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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 was conducted with Cupid Hall, Licensee, including, but not limited to Appeal Procedures and Agencies Consultative Role. --------PAGE 2
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2