198013600-6-18-2021-54-CC-ACHO-C489XL-20210621234539

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198013600
Report Date: 06/18/2021
Date Signed: 06/18/2021 04:35:06 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 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
05/05/2021 and conducted by Evaluator Justin Dorsey

COMPLAINT CONTROL NUMBER: 54-CC-20210505100305

FACILITY NAME:	CARCAMO FAMILY CHILD CARE		FACILITY NUMBER:	198013600
ADMINISTRATOR:	CARCAMO, CLAUDIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 643-4084
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90006
CAPACITY:	14	CENSUS: 5	DATE:	06/18/2021
		UNANNOUNCED	TIME BEGAN:	03:28 PM
MET WITH:	Claudia Carcamo		TIME COMPLETED:	04:32 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained injuries while in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Justin Dorsey contacted the facility to deliver the complaint investigation finding via facetime due to COVID-19 pre-cautionary measures. LPA Dorsey identified himself and discussed the purpose of the call. LPA Dorsey toured the facility and delivered the finding to the allegation thhat a child sustained an injury while in care with Licensee Claudia Carcamo, Staff #2 helped translate the conversation between LPA and licensee. During the visit there were 5 children present.

On 05/13/21, LPA Dorsey conducted an initial 10-day visit. During this visit, LPA Dorsey interviewed licensee Claudia Carcamo. While conducting the initial visit, LPA Dorsey obtained photos and videos related to the investigation. Due to insufficient information, the complaint remained open so the LPA could gather additional information.

Unsubstantiated

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: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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 6

Control Number 54-CC-20210505100305

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: CARCAMO FAMILY CHILD CARE	FACILITY NUMBER: 198013600
	VISIT DATE: 06/18/2021

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

During the investigation, LPA Dorsey interviewed the licensee and parents. According to the complaint allegation, a child sustained an injury while in care. The complainant states on 05/03/21 when they got home they observed a blood spot on Child #1’s nose. According to the complainant on 05/04/21 when they asked Staff #1 about the blood they stated that the child fell on the playground. LPA Dorsey was sent a photo that showed a child with a red spot on the child’s left nostril from the complainant. According to the complainant this photo was taken on 05/03/21 when the blood was noticed. LPA Dorsey was unable to interview Child #1 due to them being an infant.

LPA Dorsey asked both the Licensee and Staff #1 if the complainant’s children have ever been injured while in care, both claim that at no point while caring for the complainant’s children have they been injured. LPA Dorsey also spoke to parents of the program, according to Parent #1 other than the normal injuries that occur when their child is playing no serious injuries have occurred while their child is in care. Parent #1 also added that when an injury does occur the licensee communicates to the them what occurred.

Based on interviews, documentation gathered and conflicting statements presented above, the allegation has been determined to be unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit phone interview was conducted with licensee Claudia Carcamo and Staff #2, a copy of this report was signed by LPA Dorsey. This report along with the LIC 9058 will be sent via email to licensee 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: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 6

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
05/05/2021 and conducted by Evaluator Justin Dorsey

COMPLAINT CONTROL NUMBER: 54-CC-20210505100305

FACILITY NAME:	CARCAMO FAMILY CHILD CARE		FACILITY NUMBER:	198013600
ADMINISTRATOR:	CARCAMO, CLAUDIA		FACILITY TYPE:	810
ADDRESS:	1656 S. ARDMORE AVE.		TELEPHONE:	(323) 643-4084
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90006
CAPACITY:	14	CENSUS:	DATE:	06/18/2021
		UNANNOUNCED	TIME BEGAN:	03:28 PM
MET WITH:	Claudia Carcamo		TIME COMPLETED:	04:32 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee did not inform parent of child's injury

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Justin Dorsey contacted the facility to deliver the complaint investigation finding via facetime due to COVID-19 pre-cautionary measures. LPA Dorsey identified himself and discussed the purpose of the call. LPA Dorsey toured the facility and delivered the finding to the allegation that the licensee did not inform parent of child's injury with Licensee Claudia Carcamo, Staff #2 was also present to translate the converation between LPA and licensee. During the visit there were 5 children present.

On 05/13/21, LPA Dorsey conducted an initial 10-day visit. During this visit, LPA Dorsey interviewed licensee Claudia Carcamo. While conducting the initial visit, LPA Dorsey obtained photos and videos related to the investigation. Due to insufficient information, the complaint remained open so the LPA could gather additional information.

Unsubstantiated

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: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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

LIC9099 (FAS) - (06/04)

Page: 5 of 6

Control Number 54-CC-20210505100305

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: CARCAMO FAMILY CHILD CARE	FACILITY NUMBER: 198013600
	VISIT DATE: 06/18/2021

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

During the investigation, LPA Dorsey interviewed the licensee and parents. According to the complaint allegation, the licensee did not inform parent of child’s injury. LPA Dorsey interviewed the complainant who claims that they were not informed about an injury that occurred 05/03/21. The complainant states that 05/03/21 they found blood on the child’s nostril. When the complainant asked Staff #1 about the blood on 05/04/21, they stated that Child #1 fell while playing. LPA Dorsey received a photo from the licensee which shows a red spot covering most of the child’s upper left nostril. LPA Dorsey was unable to interview Child #1 due to them being an infant.

LPA Dorsey asked both the Licensee and Staff #1 if the complainant’s children have ever been injured while in care, both claim that at no point while caring for the complainant’s children have they been injured. LPA Dorsey also spoke to parents of the program, according to Parent #1 other than the normal injuries that occur when their child is playing no serious injuries have occurred while their child is in care. Parent #1 also added that when an injury does occur the licensee communicates to the them what occurred.

Based on interviews, documentation gathered and conflicting statements presented above, the allegation has been determined to be unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit phone interview was conducted with licensee Claudia Carcamo and Staff #2, a copy of this report was signed by LPA Dorsey. This report along with the LIC 9058 will be sent via email to licensee 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: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC9099 (FAS) - (06/04)

Page: 6 of 6