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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197700256
Report Date: 07/24/2020
Date Signed: 10/08/2020 01:18:51 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2020 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20200625103316
FACILITY NAME:RYERSON FAMILY CHILD CAREFACILITY NUMBER:
197700256
ADMINISTRATOR:RYERSON, TERIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 291-2330
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:14CENSUS: 5DATE:
07/24/2020
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TERI RYERSON, LICENSEETIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Personal Rights: On 06/24/20, child sustained unexplained scratches on the left side of the face while in care.

Reporting Requirements: Licensee failed to contact the Department to file an Unusual Incident Report.
INVESTIGATION FINDINGS:
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THIS IS AN AMENDED REPORT FOR THE REPORT DATED 7/24/2020.

On July 24, 2020, at 11:00 AM, Licensing Program Analyst, Loyce Phillips, contacted Licensee for the purpose of delivering the findings of the above complaint investigation. Due to COVID-19, this visit was conducted via Tele-Visit.

The investigation consisted of interviews with licensee, staff and other complaint pertinent parties. Interviews conducted revealed child sustained scratches that resulted in 5 superficial wounds on the left side of the face while in care. The investigation revealed on June 24, 2020 during an earthquake drill, the children went under a table. When the children came from underneath the table, Licensee and licensee’s assistant observed the child with scratches. The child did not require medical attention; therefore, the Licensee did not need to report an unusual incident. Based on the information obtained during the investigation, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. No deficiencies cited.

See complaint investigation report LIC 9099C for additional information.

Unsubstantiated
Estimated Days of Completion: 60
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (661) 305-5243
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020
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 3
Control Number 12-CC-20200625103316
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: RYERSON FAMILY CHILD CARE
FACILITY NUMBER: 197700256
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/24/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
08/07/2020
Section Cited
CCR
102423(a)(2)
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Personal Rights (a) 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 of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful...
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LPA emailed licensee a copy of Title 22 regulation regarding personal rights. Licensee agreed to submit a written and signed statement by 8/7/2020 indicating how she will ensure children receive a safe environment and how she will protect the personal rights at all times.
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This requirement was not met as evidenced by: During the complaint investigation, it was disclosed that on 06/24/20, child sustained scratches that resulted in 5 superficial wounds on the left side of the face; however, licensee and licensee’s assistant were unaware of how child was injured. The injuries did not require medical attention. This is a type B deficiency that if not corrected, it could become a risk to the health, safety or personal rights to children in care.
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Deficiency Dismissed
Type B
08/07/2020
Section Cited
CCR
102416.(b)(3)(C)
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Reporting Requirement(b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. (3) Health and Safety Code Section 1597.46(b)(1) provides in part:(C)Any unusual incident or child
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LPA emailed licensee a copy of Title 22 regulation regarding reporting requirements. Licensee shall submit a statement to the Department by 08/07/2020 that she has read and understands the regulation.
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absence that threatens the physical or emotional health or safety of any child." This requirement was not met as evidenced by Licensee failed to contact the Department to report the incident. This is a type B deficiency that if not corrected, it could become a risk to the health, safety personal rights to children in care.
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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: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (661) 305-5243
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20200625103316
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: RYERSON FAMILY CHILD CARE
FACILITY NUMBER: 197700256
VISIT DATE: 07/24/2020
NARRATIVE
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An exit interview was conducted, a Notice of Site Visit and Appeal Rights was discussed, and a copy of this report was read and forwarded to the Licensee via email for confirmation with “Read Receipt” on this date.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (661) 305-5243
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3