198011812-4-21-2021-33-CC-ACHO-C34VFN-20210517162410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198011812
Report Date: 04/20/2021
Date Signed: 04/21/2021 10:24:59 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/08/2021 and conducted by Evaluator Justin Dorsey

COMPLAINT CONTROL NUMBER: 33-CC-20210408142858

FACILITY NAME:	CAJINA FAMILY CHILD CARE		FACILITY NUMBER:	198011812
ADMINISTRATOR:	CAJINA, ZOYLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 913-9360
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY:	14	CENSUS: 0	DATE:	04/20/2021
		UNANNOUNCED	TIME BEGAN:	05:13 PM
MET WITH:	Zoya Cajina		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Children are being cared for in an unsafe area of the home.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Justin Dorsey contacted the facility via facetime to deliver the complaint investigation findings due to COVID-19 and pre-cautionary measures. LPA Dorsey identified himself and discussed the purpose of the call. LPA Dorsey delivered the finding to licensee Zoyla Cajina and Family Member #1 who helped translate the conversation between LPA and licensee.

During this investigation, LPA Dorsey conducted interviews, obtained copies of the children's roster and photos of the home's back converted garage.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2021

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 33-CC-20210408142858

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CAJINA FAMILY CHILD CARE	FACILITY NUMBER: 198011812
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/20/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/11/2021 Section Cited CCR 102352(f)(1)	1 2 3 4 5 6 7	102352 Definitions (f)(1) "Family Day Care"... means regularly provided care, protection and supervision of children, in the care giver's own home, for periods of less than 24 hours per day, while the parents or authorized representatives are away...This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Per licensee she will move the necessary child care equipment from the converted garage to the licensed home to resume primary care in home and send LPA Dorsey photos of the move by POC due date of 05/11/21.
	8 9 10 11 12 13 14	Based on observation and interview the home uses the converted garage in the homes backyard as the primary care area for children in care, which poses a potential Health, Safety or Personal Rights risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2021

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20210408142858

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CAJINA FAMILY CHILD CARE	FACILITY NUMBER: 198011812
	VISIT DATE: 04/20/2021

NARRATIVE

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On 4/16/21 Staff #1 took LPA on a tour of the home and the rear converted garage. LPA observed the garage to be equipped with tables, chairs, mats for napping, toys, a changing table for infants, cubbies for children’s personal belongings, sign-in sheet logs, and licensing posting requirements (observed in front of the home as well). According to staff interviewed, children wash their hands upon arrival at a portable sink located in front of the home and head to the converted garage for care. Interviews found that meals are prepared in the home and served in the covered patio area. LPA also confirmed with staff that children nap in the garage where mats and napping equipment were observed.

Per licensee, she has been using the converted garage once or twice a week for primary use of her daycare since January 2021. Licensee stated she began using the converted garage for primary use to spread the children out during the pandemic. At this time the home is not being used for care, other than napping and meal preparation. Licensee added children spend most of their time outdoors.

Licensee stated that she is going through the process of getting her converted garage permitted for use of her childcare. Licensee provided receipt of payment for permit renewal fees from the City of Los Angeles dated 11/24/2020. Although documentation confirms that a fee was submitted for permit, the department has not received documentation from the City of Los Angeles indicating that the home has been granted use of the garage as an area of the home to be used for childcare. Licensee was reminded that the home must be used for care and that a new facility sketch will need to be submitted should the city deem the garage area habitable for daycare use.

Based on LPA's observations, documents, and interviews the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division 12, Chapter 1) was cited on 04/20/21.

An exit phone interview was conducted with licensee Cajina and Family Member #1, a copy of this report was signed by LPA Dorsey. This report along with the LIC 9058 will be sent via email to licensee Cajina who agrees to sign and date the report. This report was sent via email and an electronic read receipt confirms receiving the report. The facility representative was provided with the mailing address for the Monterey Park Regional office and agrees to send the original report by mail.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2021

LIC9099 (FAS) - (06/04)

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