198002467-7-2-2019-33-CC-BVON-BEN2BD-20190801171458

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198002467
Report Date: 07/02/2019
Date Signed: 07/02/2019 01:47:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2019 and conducted by Evaluator Rita Ramos

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20190502085841

FACILITY NAME:	LUIS, MELINDA FAMILY DAY CARE		FACILITY NUMBER:	198002467
ADMINISTRATOR:	LUIS, MELINDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 258-5330
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90065
CAPACITY:	14	CENSUS: 11	DATE:	07/02/2019
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Melinda Luis, Licensee		TIME COMPLETED:	02:05 PM

ALLEGATION(S):

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Licensee hit daycare child while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced complaint inspection to the above facility. LPA met with Melinda Luis, Licensee, who guided analyst on a tour of the facility. Also present during the inspection was Samuel Luis, Licensee's husband. There were 11 children present upon arrival.

During the investigation LPA conducted interviews with Licensee, children, parent, other personnel, obtained copies of facility roster, and took pictures of supporting information.

Information provided by the Complainant indicates that Child #1 was hit by Licensee while in care.

Licensee disclosed that they do not hit the children in care and that a belly patting game may have been misconstrued as hitting by Child#1.

-------------Page 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019

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 33-CC-20190502085841

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LUIS, MELINDA FAMILY DAY CARE	FACILITY NUMBER: 198002467
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/02/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/03/2019 Section Cited CCR 10223(a)(3)	1 2 3 4 5 6 7	Personal Rights To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating,	1 2 3 4 5 6 7	Licensee will watch Pesonal Rights video from the Department's website and submit a written summary of what was viewed, what they learned, and what they will do in order to prevent Personal Rights violations.
	8 9 10 11 12 13 14	sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement is not met as evidenced by Child #2, #3, #4's disclosure, and Adult #1's disclosure that Licensee hit Child #1. This poses an immediate 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: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 33-CC-20190502085841

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LUIS, MELINDA FAMILY DAY CARE	FACILITY NUMBER: 198002467
	VISIT DATE: 07/02/2019

NARRATIVE

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Adult #1 stated that Child #1 disclosed to them that Licensee hit Child #1.

Child #1 made no disclosures.

When interviewing Children, Child #2 disclosed that Licensee does not hit Child #4, #3, or #2 but only hits Child #1. Child #3 disclosed that Licensee hit Child #1. When interviewing Child #4, Child #4 did not disclose that Licensee hit Child #1, however, disclosed that they do not think that Licensee likes Child #1.

Parent of Child #1 disclosed that Adult #1 informed them that Child #1 stated that Licensee hit Child #1, however, Parent #1 does not think it happened.

Based on LPAs observations, interviews which were conducted, and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 Chapter 1 Personal Rights 101223(a)(3), is being cited on the attached deficiencies page.

LPA read the report to Licensee and requested that Licensee read the report, however, Licensee refused to sign this Complaint Report.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee/Director.

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. Exit interview was conducted with Melinda Luis, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. -----------Page 2 of 2

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019

LIC9099 (FAS) - (06/04)

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