197700297-5-17-2021-12-CC-CBEL-C4RT5W-20210709142609

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197700297
Report Date: 05/17/2021
Date Signed: 05/17/2021 02:19:04 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
05/13/2021 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20210513152148

FACILITY NAME:	BYRNE FAMILY CHILD CARE		FACILITY NUMBER:	197700297
ADMINISTRATOR:	BYRNE, APRIL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 886-1120
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	14	CENSUS: 9	DATE:	05/17/2021
		UNANNOUNCED	TIME BEGAN:	09:59 AM
MET WITH:	Licensee April Byrne		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Uncleared adult providing care to children.

INVESTIGATION FINDINGS:

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On May 17, 2021, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted a complaint inspection on the above allegation. LPA stated the purpose of the inspection, and was permitted entry by Licensee's assistant (Staff 1). Licensee was not home during initial inspection. Upon entry, LPA counted 7 children in care and observed two adults providing care to the children (not on association list). Licensee arrived at 10:52 AM with 2 additional children.

According to Licensee, Staff 1 is fingerprint cleared and Staff 2 is "observing" and is not yet fingerprint cleared. Staff 2 has been observing 3 days a week for the last 3 weeks. Staff 1 and Staff 2 are not associated to the facility. LPA verfied Staff 1 is fingerprint cleared, but not associated. LPA observed Staff 1 and Staff 2 at the facility during inspection. Staff 2 is not fingerprint cleared. At 11:40AM, Staff 2 left the premises.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2021

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 12-CC-20210513152148

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: BYRNE FAMILY CHILD CARE	FACILITY NUMBER: 197700297
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/17/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/18/2021 Section Cited CCR 102370(d)(1)	1 2 3 4 5 6 7	102370 Criminal Record Clearance (d) All individuals subject to a criminal record review... shall prior to working... in a licensed facility (1) Obtain a California clearance...as required by the Department. This requirement was not met as evidence by:	1 2 3 4 5 6 7	Licensee will ensure Staff 2 obtains a criminal record clearance prior to returning to the facility. During inspection, Staff 2 left the facility premises. Licensee shall provide declaration to the Department stating she will not
	8 9 10 11 12 13 14	Based on observation, interview, and record review: Licensee did not ensure Staff 2 obtained a criminal record clearance prior to working at the facility, which poses an immediate Health and Safety risk to chidlren in care.	8 9 10 11 12 13 14	permit uncleared adults at the facility and will not allow Staff 2 to return to the facility until she is fingerprint cleared no later than 05/18/21.
	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: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 12-CC-20210513152148

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: BYRNE FAMILY CHILD CARE	FACILITY NUMBER: 197700297
	VISIT DATE: 05/17/2021

NARRATIVE

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Based on evidence obtained and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 Chapter 1 102370(d)(1) Criminal Record Clearance Type A violation is being cited.

A Civil Penalty of $500 has been assessed during this inspection for staff criminal record clearance. Payment is due when billed. and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent. A copy of the Acknowledgment of receipt of licensing report (LIC9224) was
provided and must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

An exit interview was conducted, a copy of this Report, Appeal Rights, and Notice of Site Visit was provided to Licensee.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2021

LIC9099 (FAS) - (06/04)

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