197492777-3-3-2022-30-CC-KSTS-CCAW5D-20220307155855

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197492777
Report Date: 03/03/2022
Date Signed: 03/03/2022 01:39:32 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
11/22/2021 and conducted by Evaluator Dalicia Adkins

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211122084738

FACILITY NAME:	ALLEN FAMILY CHILD CARE		FACILITY NUMBER:	197492777
ADMINISTRATOR:	ALLEN, EBONI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 812-3683
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90047
CAPACITY:	14	CENSUS: 0	DATE:	03/03/2022
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Licensee, Eboni Ellen		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility has rodents

Facility is in disrepair

INVESTIGATION FINDINGS:

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On 3/3/2022 at 10:45am, Licensing Program Analyst (LPA) Dalicia Adkins conducted an unannounced complaint visit and met with licensee Allen Eboni, LPA Adkins informed licensee about the purpose of the visit

The purpose of today's visit it to deliver finding of the above-mentioned allegations. Licensee informed LPA that the facility is closed and last day of operation was 2/25/2022. LPA observed closed sign on door and no children in care. Licensee stated that she is in the process of moving and will be out the home within the next two weeks.

LPA collected supportive document: copy of Superior Court of California, County of Los Angeles Civil Division.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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-20211122084738

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: ALLEN FAMILY CHILD CARE	FACILITY NUMBER: 197492777
	VISIT DATE: 03/03/2022

NARRATIVE

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LPA did not observe any rodents or rodent dropping in the home. Although there may have been rodents in the home prior to licensing inspections there were no rodents in the home at the time of the inspection. LPA observed the home to be clean, orderly, and free from defects or conditions which might endanger a child.

Licensee demonstrated efforts to resolve the infestation issue by placing mice traps and requesting assistance from the owner to have the rental property exterminated.

Licensee disclosed that there were no mice in the home since licensing last visit on 11/30/2021. On 1/28/2022 exterminator inspected the home and placed mice traps and stated that he did not see any dead rodents. On 2/8/2022 exterminator came back to follow up, there were no mice on trapping. Exterminator treated the outside area around the home.

Based on observations, interviews, record reviews, it was determined that the above allegations to be unsubstantiated. Unsubstantiated- A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

There were no deficiencies cited during this visit.

Exit interview conducted and this report reviewed with licensee.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

LIC9099 (FAS) - (06/04)

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