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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198008375
Report Date: 04/22/2022
Date Signed: 04/22/2022 01:37:56 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
12/16/2021 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20211216135948
FACILITY NAME:MERRIMAN FAMILY CHILD CAREFACILITY NUMBER:
198008375
ADMINISTRATOR:MERRIMAN, JACQUELINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 864-5534
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:14CENSUS: 2DATE:
04/22/2022
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Jacqueline MerrimanTIME COMPLETED:
01:57 PM
ALLEGATION(S):
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Personal Rights
Neglect/Lack of Supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection on 04/22/2022 at 12:50am and met with Licensee Jacqueline Merriman. LPA conducted today's inspection to deliver the findings of the above allegations. There were two children present with three staff.

During the course of the investigation, LPA Navarro conducted interviews with the Reporting Party, Licensee, Staff, Children in care, and Parents. Reporting Party alleged that day care child was hit at the facility and that children were supervised by intoxicated adults. Licensee and staff interviewed denied the allegations. There were no corroborating statements made in interviews with parents and children. Based on the interviews conducted and documentation obtained it has been determined that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove if the alleged violations did or did not occur, therefore at this time the above allegations are unsubstantiated.

Report continues on the next page

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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 2
Control Number 54-CC-20211216135948
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: MERRIMAN FAMILY CHILD CARE
FACILITY NUMBER: 198008375
VISIT DATE: 04/22/2022
NARRATIVE
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Exit interview was conducted with Licensee Jacqueline Merriman. The notice of site visit was given to the Licensee and must remain posted for 30 days.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2