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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198011564
Report Date: 08/23/2022
Date Signed: 08/23/2022 11:27:25 AM

Substantiated


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
06/10/2022 and conducted by Evaluator Randy Derraco
COMPLAINT CONTROL NUMBER: 54-CC-20220610152345
FACILITY NAME:SANDERS & POPE FAMILY CHILD CAREFACILITY NUMBER:
198011564
ADMINISTRATOR:LAURIE S. & SHAQUINTA P.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 594-1116
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY:14CENSUS: 7DATE:
08/23/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Co-Licensee - Shaquinta PopeTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Licensee did not notify authorized representative of incident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Randy Derraco conducted an unannounced complaint inspection to the above mention facility on 08/23/22. LPA arrived at the facility at 9:45AM and was met by Co-Licensee, Shaquinta Pope, who guided analyst on a tour of the facility. Also in attendance were adults A2 and A3. LPA observed there were 7 children in care. The purpose of this visit is to deliver complaint findings to the above mentioned allegation. LPA observed the facility to be clean and in good repair.

Based on record review, observations, and interviews, LPA was able to confirm that the incident took place on 06/07/22 at approximately 4:15 PM. The children in attendance that day had just arrived for care and were playing in the backyard play area when C1 struck C2 in the head while riding a Razor scooter causing C2 to bleed. Staff provided first aid immediately and montiored C2 for an approximately 1 hour, not allowing C2 to sleep because of the possiblity of a concussion. The authorized representative was informed of the incident at approximately 11:00 PM during child pick up. The co-licensee also provided the authorized representative with an "ouchie report" on 06/08/22, that details the the events of the incident.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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 3
Control Number 54-CC-20220610152345
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: SANDERS & POPE FAMILY CHILD CARE
FACILITY NUMBER: 198011564
VISIT DATE: 08/23/2022
NARRATIVE
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Even though the authorized representative or the facility staff did not seek medical attention of a doctor after the incident had occurred, there was enough concern from the co-licensees about the possibility of a concussion with C2 to warrant keeping the child awake for at least an hour. Based on LPA's observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Health and Safety Code section 1597.467(a) (Title 22, Division 6 Chapter Number 3.6 Family Day Care Homes), are being cited on the attached LIC 9099D.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights provided, and report was reviewed with the co-licensee Shaquinta Pope.

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20220610152345
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: SANDERS & POPE FAMILY CHILD CARE
FACILITY NUMBER: 198011564
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/23/2022
Section Cited
HSC
1597.467(a)
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1597.467 Injury or Acts of Violence Reporting Requirments (a) Whenever any licensee... has reasonable cause to believe that a child in his or her care has suffered any injury... while under the licensee's care, the licensee shall, as soon as possible, report that injury... to parent...of that child. This requirement is not met as evidence by:
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Co-licensee states she will begin to provide an ouchie report to the authorized representative, notify the authorized representative by phone or text of the incident, and complete an Unusual Incident Report for the Department for any similar incident in the future.
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Based on observation, interview and record review, the co-licensee did not report the injury to the parent as soon as possible, which poses a potential health, safety, and/or personal rights risk to persons 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3