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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198008295
Report Date: 10/25/2019
Date Signed: 10/25/2019 10:22:29 AM



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
08/16/2019 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20190816135808
FACILITY NAME:GRAVES FAMILY CHILD CAREFACILITY NUMBER:
198008295
ADMINISTRATOR:GRAVES, TONNETTE'FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 480-2120
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:14CENSUS: 3DATE:
10/25/2019
UNANNOUNCEDTIME BEGAN:
09:26 AM
MET WITH:Tonnette GravesTIME COMPLETED:
10:42 AM
ALLEGATION(S):
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Day-care child hit while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection on today's date. LPA met with Tonnette Graves who guided LPA on a tour of the facility. There was a total of three children present during todays inspection.

During the course of the investigation LPA interviewed the Licensee, staff, and day-care children. Staff and children interviewed stated Staff #1 softly placed fingers on Child #1 mouth to quiet her. Based on information obtained by the interviews conducted the preponderance of evidenced has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22 is being cited on the attached LIC 9099-D.

Exit interview was conducted with the Licensee Tonnette Graves. Notice of Site Visit and Appeal rights were given and explained. Visit was conducted in Spanish and report was translated prior to obtaining signature
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
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 54-CC-20190816135808
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GRAVES FAMILY CHILD CARE
FACILITY NUMBER: 198008295
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2019
Section Cited
CCR
102423(a)(1)
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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 of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:(1) To be treated with dignity and his/her
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Per Licensee, staff and herself will provide a written statement on the steps they will take to prevent this from happening again. Licensee will submit the written statements to LPA by the POC date of 11/01/19.
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personal relationship with staff and other persons. This requirement was not met as evidenced by interviews conducted with licensee, staff, and children. All parties interviewed stated Staff #1 gently placed their fingers on Child #1 mouth to quite them. This is a potential risk to the health and safety of the 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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
LIC9099 (FAS) - (06/04)
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