198013600-11-20-2019-54-CC-TCON-BJKMZS-20191205090338

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198013600
Report Date: 11/20/2019
Date Signed: 11/20/2019 03:15:20 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
11/06/2019 and conducted by Evaluator Denise Gibbs

COMPLAINT CONTROL NUMBER: 54-CC-20191106121124

FACILITY NAME:	CARCAMO FAMILY CHILD CARE		FACILITY NUMBER:	198013600
ADMINISTRATOR:	CARCAMO, CLAUDIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 766-9310
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90006
CAPACITY:	14	CENSUS: 5	DATE:	11/20/2019
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Claudia Carcamo, Licensee		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Licensee is retaliating against day care child's authorized representative for filing a complaint
Staff pushed day care child

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced complaint inspection on 11/20/19 at 12:00 pm to investigate the above allegations. LPA toured facility with licensee, Claudia Carcamo, Licensee. There were 5 children present during this visit.

During the course of investigation LPA made observations, conducted interviews with licensee, staff, parents, and documentation was collected. Parties interviewed made no disclosures regarding the above allegations. Interviews indicated that day care was taken of the facility by parent after licensee said child could remain in care. Licensee states that she did not witness staff push a child and she did not push a child.

Although the allegation may have happened or is valid there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

------PAGE 1

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

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 5

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
11/06/2019 and conducted by Evaluator Denise Gibbs

COMPLAINT CONTROL NUMBER: 54-CC-20191106121124

FACILITY NAME:	CARCAMO FAMILY CHILD CARE		FACILITY NUMBER:	198013600
ADMINISTRATOR:	CARCAMO, CLAUDIA		FACILITY TYPE:	810
ADDRESS:	1656 S. ARDMORE AVE.		TELEPHONE:	(323) 766-9310
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90006
CAPACITY:	14	CENSUS: 5	DATE:	11/20/2019
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Claudia Carcamo, Licensee		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Licensee engaged in verbal altercation in front of day care children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced complaint inspection on 11/20/19 at 12:00 pm to investigate the above allegation. LPA toured facility with licensee, Claudia Carcamo. There were 5 children present during this visit.

During the course of investigation LPA made observations, conducted interviews with licensee, staff, parents, and documentation was collected. Adults interviewed disclosed that they had an altercation, where voices were raised in a inappropriate manner. Adults disclosed that children were present during this altercation. Record review and interviewed confirmed child was taken out of care after this altercation due to the hostile environment.

Based on the available information, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be Substantiated. California Code of Regulations, 102423(a)(1) Personal Rights, are being cited on the attached LIC. 9099D. ------------PAGE 1

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 54-CC-20191106121124

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: CARCAMO FAMILY CHILD CARE	FACILITY NUMBER: 198013600
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/20/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 11/22/2019 Section Cited CCR 102423(a)(1)	1 2 3 4 5 6 7	102423 Personal Rights(a)(1) (a)Each child receiving services...shall have certain rights...These rights include...(1) To be treated with dignity in his/her personal relationship with staff and other persons. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee agrees to create a box for parents to write down thier suggestions and issues they may have with the facility. She will check box daily and call parents regarding the issues so they can talk about it when children are not present. Licensee will send LPA a picture of the box once she has completed it.
	8 9 10 11 12 13 14	Based on interviews, licensee engaged in an altercation with a parent at the facility while children were present, which resulted in child being taken out of care due to the hostile evniroment. This poses an immediate Health, Safety or Personal Rights risk to children in care.	8 9 10 11 12 13 14	Per licensee, if an altercation begins to occur in front the children she will ask them to step outside before takling to them.
CCR	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	8 9 10 11 12 13 14		8 9 10 11 12 13 14

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 Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 54-CC-20191106121124

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: CARCAMO FAMILY CHILD CARE	FACILITY NUMBER: 198013600
	VISIT DATE: 11/20/2019

NARRATIVE

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This poses an immediate Health and Safety risk to clients in care.

Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care for up to one year.

A copy of the Parent Notification Requirements was provided to the licensee, along with a copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports.

Exit interview was conducted with Claudia Carcamo, Licensee, including, but not limited to Appeal Procedures and Agencies Consultative Role.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 54-CC-20191106121124

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: CARCAMO FAMILY CHILD CARE	FACILITY NUMBER: 198013600
	VISIT DATE: 11/20/2019

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Claudia Carcamo, Licensee, including, but not limited to Appeal Procedures and Agencies. ------------------PAGE 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

LIC9099 (FAS) - (06/04)

Page: 5 of 5