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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198011345
Report Date: 07/17/2019
Date Signed: 07/17/2019 03:44:56 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 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
07/12/2019 and conducted by Evaluator Tiffanie Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20190712163206
FACILITY NAME:CHAVERO-RAMIREZ FAMILY CHILD CAREFACILITY NUMBER:
198011345
ADMINISTRATOR:CHAVERO, MARGARITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 233-0252
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY:14CENSUS: 13DATE:
07/17/2019
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:LicenseeTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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License- Facility is operating over capacity.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tran arrived at the above facility to conduct an initial compliant inspection for the aforementioned complaint allegation. Upon arrival, LPA greeted by licensee and her employee, about 2:00 PM we toured the home. LPA observed 13 day care children in care during the inspection. LPA completed children's file review. LPA obtained declaration statement.
Based on interviews conducted, licensee and her employee admitted on 07/10/19, the facility took care 16 child care at one time. During the investigation, licensee agrees to provide a declaration statement indicated she understand the regulations that her license capacity is 14, she will stay in complaince with the department and not to repeat this violation. Therefore, based on the preponderance of evidence, the allegation of facility is operating over the capacity is substantiated. A finding means that the complaint is substantiated and the allegation is valid because the preponderance of the evidence standard has been met.
Facility was cited type A deficiency. Please see Complaint Investigation Report LIC 9099D for deficiency cited. An exit interview was conducted with the licensee, and a notice of site visit was provided along with the appeal rights.



Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
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-20190712163206
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: CHAVERO-RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 198011345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/17/2019
Section Cited
CCR
102416.5
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Based on interview conducted, licensee and her employee admitted on 07/10/19, the facility take care 16 child care children at one time which posed an immediate Health and Safety risk to children in care.
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Licensee provided a declaration statement indicating that understand regulations and will stay in complaince with the department and not to repeat this violation.
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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: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2