198008186-9-6-2022-54-CC-VCOK-CJ3NFV-20220908102607

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198008186
Report Date: 09/06/2022
Date Signed: 09/06/2022 02:02:07 PM

Unsubstantiated

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 CENTER DR 200B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/22/2022 and conducted by Evaluator Dayna Chambers

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20220622085411

FACILITY NAME:	WILLIS FAMILY CHILD CARE		FACILITY NUMBER:	198008186
ADMINISTRATOR:	WILLIS, LOLITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 208-5054
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90804
CAPACITY:	14	CENSUS:	DATE:	09/06/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:			TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
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9

Child sustained unexplained injury

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced complaint inspection on September 6, 2022. LPA arrived at the facility at 1:00pm AM/PM. LPA met with Licensee, Lolita Willis, for the purpose of delivering the findings for the above allegation. Licensee gave LPA a tour of the facility. LPA observed 3 children in care upon arrival.

LPA Chambers inspected the facility on 06/28/22, collected documents, parents’ letters and photos of Child #1. LPA conducted interviews with licensee, parents, and staff. LPA conducted record reviews and there were no unusual incident reports or complaints submitted to the department. Parent letters and interviews did not corroborate the allegation was intentional. Photos taken of Child #1 (04/15/22) showed a pinpoint size, round, spot on the bridge of nose between eyes. Through observation during inspection on 06/28/22, and interviews conducted, the facility provides supervision of the children. The licensee and staff conduct wellness checks when children are dropped off. There is no evidence to corroborate the incident was intentional or caused by lack of supervision.

Based on interviews conducted, the above allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore these allegations are unsubstantiated.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Lolita Willis, Licensee. Appeal Rights were given and explained.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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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