197492937-5-13-2021-30-CC-KSTS-C4VV29-20210713160243

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197492937
Report Date: 05/12/2021
Date Signed: 05/13/2021 08:31:55 AM

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
04/22/2021 and conducted by Evaluator Shandra Powell

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20210422113256

FACILITY NAME:	MACK FAMILY CHILD CARE		FACILITY NUMBER:	197492937
ADMINISTRATOR:	MACK, LAKEISHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 331-5995
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	14	CENSUS: 6	DATE:	05/12/2021
		UNANNOUNCED	TIME BEGAN:	03:49 PM
MET WITH:	Lakeisha Mack, Licensee		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Licensee withheld children for an extended amount of time.

INVESTIGATION FINDINGS:

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Due to COVID-19 and precautionary measures, Licensing Program Analyst (LPA) S. Powell delivered this final finding of the above complaint allegation by use of tele-inspection with Licensee, Lakeisha Mack on 05/12/2021.

During the investigation LPA conducted interviews and received documentation which provided that the licensee withheld the children for an extended amount of time. Licensee admitted not opening the door of her home when parent came to retreive children due to her door bell (Ring) being out of order and her cell phone was left in her car for several hours, after completing a zoom meeting. Documentation (text messages) received also verified that the children were withheld for an extended amount of time. Licensee stated doorbell was serviced and a sign was posted for parents the next day of the incident. Licensee provided invoice for door bell repair to LPA on the next business day.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021

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-20210422113256

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: MACK FAMILY CHILD CARE	FACILITY NUMBER: 197492937
	VISIT DATE: 05/12/2021

NARRATIVE

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Based on the information obtained and interviews conducted by LPA, it has been determined that Licensee is in violation of Title 22, Division 12 Chapter 1 - 102417 Operation of a Family Child Care Home (c)The home shall maintain telephone service.

Due to the parent not being able to reach the licensee to pick up children the requirement was not met therefore, the complaint allegation of licensee withheld the children for an extended amount of time is Substantiated.

Due to COVID-19 and precautionary measures, an exit phone interview was conducted with Mack and a copy of this report was signed by LPA Shandra Powell. This report will be sent via email to Mack who agrees to sign and date the report. The Licensee was provided with the mailing address of the El Segundo Regional office and agrees to send a signed copy of this report by mail. A copy of the appeal rights (LIC9058 01/16) were also provided.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021

LIC9099 (FAS) - (06/04)

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Control Number 30-CC-20210422113256

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: MACK FAMILY CHILD CARE	FACILITY NUMBER: 197492937
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/12/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/17/2021 Section Cited CCR 102417(c)	1 2 3 4 5 6 7	Operation of a Family Child Care Home The home shall maintain telephone service. This requirement is not met as evidenced by Licensee cell phone was not available during Child Care Hours and parents were unable to communicate with licensee.	1 2 3 4 5 6 7	Licensee agrees to submit a written plan on a declaration form LIC855 of correction regarding maintaining telephone service at all times during child care hours. Licensee will provide LIC855 by POC date 05/17/2021
	8 9 10 11 12 13 14	This poses a potential Health and safety risk to children 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: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021

LIC9099 (FAS) - (06/04)

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