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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419908
Report Date: 10/09/2020
Date Signed: 10/09/2020 03:33:39 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
05/18/2020 and conducted by Evaluator Denise Gibbs
COMPLAINT CONTROL NUMBER: 54-CC-20200518140457
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: 10DATE:
10/09/2020
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Cupid Hall, LicenseeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee did not provide adequate supervision to children in the home.
INVESTIGATION FINDINGS:
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This was a complaint inspection conducted by Denise Gibbs, Licensing Program Analyst (LPA) on 10/9/20 at 2:00 PM. Due to COVID-19 and precautionary measures, this complaint was conducted with Cupid Hall, Licensee via Zoom for the purpose of delivering findings.

During the investigation conducted by Laura Garcia, Investigation Bureau (IB), interviews were conducted with the Licensee, staff, children, parents, victim's family members, Social Worker, and medical staff. Also, during this investigation children’s roster, police report, medical record and text message video were obtained and reviewed.

Based on documents obtained and interviews conducted, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is 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: 10/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020
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-20200518140457
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: 10/09/2020
NARRATIVE
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No deficiencies will be cited today 10/9/2020.

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 via Zoom, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Licensee's signature. -----------PAGE 2
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2