197420069-1-17-2020-30-CC-VBAA-BME4LU-20200304181229

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197420069
Report Date: 01/17/2020
Date Signed: 01/17/2020 03:45:52 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
01/16/2020 and conducted by Evaluator Claudia Escobedo

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20200116140503

FACILITY NAME:	EZRA FAMILY CHILD CARE		FACILITY NUMBER:	197420069
ADMINISTRATOR:	EZRA, ESTER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 399-0021
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	14	CENSUS: 13	DATE:	01/17/2020
		UNANNOUNCED	TIME BEGAN:	12:59 PM
MET WITH:	Licensee-Ester Ezra		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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License-Out of Ratio-Infants in Care

INVESTIGATION FINDINGS:

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On 01/17/2020 at 12:59 p.m., Licensing Program Analyst (LPA) Escobedo conducted an unannounced 10-day complaint investigation regarding the above allegations. LPA Escobedo met with Licensee, Ester Ezra.

LPA interviewed Licensee, Staff 1 and reviewed children's records. Licensee states that she operates her child care Monday-Thursday-8:00 a.m.-4:30 p.m. and Friday-8:00 a.m.-3:00 p.m. LPA observed 13 children in care. 4 of the 13 children (Child 1, Child 2, Child 12 and Child 13) in care are under 2-years of age. Licensee states that Child 1, Child 2, Child 12 and Child 13 are under 2 years of age.

After reviewing records and interview with Licensee that were consistent with verifying the ages and number of children present, the allegation of out of ratio is substantiated. At 2:59 p.m., Licensee stated that she will ensure that the ages of children reflect the regulated ratio of children in care.

Continued LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 30-CC-20200116140503

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: EZRA FAMILY CHILD CARE	FACILITY NUMBER: 197420069
	VISIT DATE: 01/17/2020

NARRATIVE

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There was one deficiency cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. See LIC 9099-D for additional information.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

An exit interview was conducted and Plans of Corrections were reviewed and developed with the Licensee. A copy of report and appeal rights were discussed and left with Licensee, Ester Ezra, whose signature on this form confirm receipt of these documents.

SUPERVISOR'S NAME: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

LIC9099 (FAS) - (06/04)

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Control Number 30-CC-20200116140503

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: EZRA FAMILY CHILD CARE	FACILITY NUMBER: 197420069
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/17/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/18/2020 Section Cited CCR 102416.5(d)(2)(b)	1 2 3 4 5 6 7	102416.5(d)(2)(b)-Staffing Ratio and Capacity-For a Large Family Child Care Home, the maximum number of children for whom care may be provided... No more than three infants are cared for during any time when more than 12 children are being cared for. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will ensure to meet ratio regulations for children in care by verifying the ages and the number of children in care.
	8 9 10 11 12 13 14	Based on record review, observation and interview, the Licensee did not ensure proper ratios for 4 of the 13 children in care, which poses an immediate Health, Safety or Personal Rights risk to persons in care.	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: Victor Bautista	TELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

LIC9099 (FAS) - (06/04)

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