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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197493843
Report Date: 11/10/2022
Date Signed: 11/10/2022 11:35:14 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
09/15/2022 and conducted by Evaluator Laticia S Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20220915134422
FACILITY NAME:ESCOBAR FAMILY CHILD CAREFACILITY NUMBER:
197493843
ADMINISTRATOR:ESCOBAR, MAYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 370-4161
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY:14CENSUS: 8DATE:
11/10/2022
UNANNOUNCEDTIME BEGAN:
10:09 AM
MET WITH:Mayra EscobarTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Licensee is operating outside of license terms and conditions
Licensee uses unusual form of punishment on day care children
Licensee denies drinking water to day care children
Licensee does not provide proper supervision to children in care
INVESTIGATION FINDINGS:
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On 11/10/2022 at 10:09AM Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced visit to the facility listed above. The purpose of the visit was to deliver the findings of the complaint received on 09/15/2022 regarding the allegations above. During todays visit LPA observed 3 staff members, 8 children and a Child Development Specialist.

During the investigation LPA conducted an observation during both unannounced visits, on 09/21/2022 and 11/10/2022. On 09/21/2022 LPA interviewed staff and obtained a copy of the children's roster and copies of supporting documentation.

Upon arrival on 9/21/2022 and 11/10/2022, LPA observed that the facility was within ratio. LPA observed that children were properly supervised by 2 staff members while playing in the backyard area, during lunch and during nap time. LPA observed sippy cups and baby bottles containing liquids. LPA observed an igloo insulated container containing water. LPA did not observe inappropriate discipline to children by staff.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
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 58-CC-20220915134422
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ESCOBAR FAMILY CHILD CARE
FACILITY NUMBER: 197493843
VISIT DATE: 11/10/2022
NARRATIVE
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LPA observed children were fully clothed including the wearing of shoes while in the back yard play area. There were two infants that were not wearing shoes due to their age.

Based on an interview with licensee and staff, children are supervised at all times. Staff has an alternating schedule when children are napping to ensure children are supervised at all times.

Based on interviews with Parent #1, Parent #3, Parent #4 and Parent #10 children are fully clothed when picked up, children are not bathed at the facility and has not experienced any form of inappropriate discipline.

Children were not interviewed due to their age.

Although the allegations 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.

An exit interview was conducted with Mayra Escobar in which this report was reviewed and signed. Licensee was provided a copy of the Facility Complaint Report (LIC 9099), Notice of Site Visit (LIC 9213) including, Provider Rights, Appeal Procedures (LIC 9058) and Agencies Consultative Role.

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.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC9099 (FAS) - (06/04)
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