197494080-1-12-2021-30-CC-KSTS-BXF4R5-20210119181921

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197494080
Report Date: 01/12/2021
Date Signed: 01/12/2021 12:29:22 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
10/21/2020 and conducted by Evaluator Laticia S Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20201021123759

FACILITY NAME:	AMADOR FAMILY CHILD CARE		FACILITY NUMBER:	197494080
ADMINISTRATOR:	AMADOR, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 674-7261
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS:	DATE:	01/12/2021
		UNANNOUNCED	TIME BEGAN:	12:04 PM
MET WITH:	Jennifer Amador		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Personal Rights - Adult in home spoke inappropriately to day-care children
Personal Rights - Day-care child's needs are not being met

INVESTIGATION FINDINGS:

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Due to Safer at Home order issued by California State Governor Newsom, on 01/12/2021 at 12:16pm, Licensing Program Analyst (LPA) Laticia Thompson conducted a Tele-Conference with Jennifer Amador, for the purpose of concluding the investigation into the allegations of personal rights, complaint number 30-CC-20201021123759. During today’s Tele-Conference there are 9 children present

This Department has investigated the allegation of the complaint. Based on interviews conducted and other evidence obtained throughout the course of the investigation, it was revealed that the facility violated the children personal rights by yelling and using inappropriate language toward children under care. Therefore, the allegation is substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted, and Plans of Correction were reviewed and developed with the Licensee. A copy of this report (LIC 9099 & LIC 9099D) and appeal rights were emailed to the Licensee. Licensee has been instructed to reply to this email acknowledging receipt

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2021

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-20201021123759

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: AMADOR FAMILY CHILD CARE	FACILITY NUMBER: 197494080
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/12/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/12/2021 Section Cited CCR 102423(a)(1)	1 2 3 4 5 6 7	102423(a)(1) Personal Rights Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless...(1)To be treated with dignity in his/her personal relationship with staff and other persons.This requirement was not met by	1 2 3 4 5 6 7	On 12/14/20 a Non Compliance Conference (NCC) was conducted with licensee, Licensee shall not yell or use inappropriate language when communicating with children under care.
	8 9 10 11 12 13 14	Based on observation and interviews staff yelled and used inappropriate language to children which posses a potential Health, Safety or Personal Rights Risk to children in care.	8 9 10 11 12 13 14	Licensee shall adhere to all POC's as discussed in the NCC, review CCLD trainings pertaining to care and supervision of children, remain in compliance at a times. License has been placed on required visits.
	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: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2021

LIC9099 (FAS) - (06/04)

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