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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197420069
Report Date: 02/19/2020
Date Signed: 02/19/2020 12:45:20 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 CAREFACILITY NUMBER:
197420069
ADMINISTRATOR:EZRA, ESTERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 399-0021
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91364
CAPACITY:14CENSUS: 12DATE:
02/19/2020
UNANNOUNCEDTIME BEGAN:
10:42 AM
MET WITH:Licensee-Ezra EsterTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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9
Licensee exceeds 20 percent of the hours that the facility is providing care per day
Facility out of ratio
INVESTIGATION FINDINGS:
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On 02/19/2020 at 10:42 a.m. Licensing Program Analyst (LPA) Escobedo, conducted an unannounced follow-up complaint investigation visit regarding the above allegations. LPA met with the Licensee, Ester Ezra.

LPA Escobedo interviewed Licensee and Staff #1. Licensee provided LPA Escobedo with a copy of LIC 9040-Child Care Facility Roster. LPA observed 12 children in care (3 of the 12 children are infants) and Staff #1.

During the interview beginning at 10:55 a.m., Staff #1 states that Licensee is always present in the home during hours of child care.

During the interview beginning at 12:05 p.m., Licensee states that she is present in the home during child care hours. Licensee states that she is aware of ratios and does not leave the assistant alone with the children in care.
Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
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 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: 02/19/2020
NARRATIVE
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Although the allegations may have occurred or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

No deficiencies were cited during today's visit in accordance with the California Code of Regulations Title 22, Division 12, Chapter 1.

An exit interview was conducted with the Licensee. A copy of this report was discussed and left with Licensee, Ester Ezra, whose signature on this form confirms receipt of this documents.
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2