198014759-3-15-2022-12-CC-SHEG-CCTU5U-20220324151719

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198014759
Report Date: 03/02/2022
Date Signed: 03/15/2022 12:14:37 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/09/2021 and conducted by Evaluator Justin Dorsey

COMPLAINT CONTROL NUMBER: 12-CC-20210909155852

FACILITY NAME:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	198014759
ADMINISTRATOR:	GARCIA, CARLOTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 764-4376
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY:	14	CENSUS: 5	DATE:	03/02/2022
		UNANNOUNCED	TIME BEGAN:	03:27 PM
MET WITH:	Carlota Garcia		TIME COMPLETED:	04:49 PM

ALLEGATION(S):

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Operation of a Family Child Care Home – Licensee failed to supervise children in care
Personal Rights – Adult #3’s conduct threaten the health and safety of children in care

INVESTIGATION FINDINGS:

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03/15/22, this is an amended Complaint Investigation Report issued on March 2, 2022. Licensing Program Analysts (LPAs) Justin Dorsey and Justeene Tamayo conducted an unannounced investigation to deliver complaint findings for the above allegations. LPAs toured the facility and observed 5 children in care with the licensee providing supervision. During this inspection licensee’s assistant Henry Garcia assisted LPAs to translate from English to Spanish between LPAs and Licensee.

The investigation was conducted by Investigator Edward Hector. The investigation consisted of interviews with licensee and all parties involved. Statements obtained during the investigation revealed that on more than one occasion on or about 2012 to 2016, adult #3 exhibited inappropriate behavior and conduct in front of child #1, child #2, child #3 and child #4.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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 12-CC-20210909155852

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 198014759
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/02/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 03/09/2022 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	102417 Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times...This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Per licensee she will write statement on how the family child care home plans to provide care and supervision to children and send to LPA Dorsey by POC due date 03/09/22.
	8 9 10 11 12 13 14	Based on the evidence obtained during the investigation, it is determined that licensee failed to provide supervision in the home resulting in child #1, child #2, child #3 and child #4 being exposed to inappropriate behavior by adult #3. This is a type A deficiency which poses an immediate Health, Safety and Personal Rights risk to children in care.	8 9 10 11 12 13 14
Request Denied Type A 03/09/2022 Section Cited CCR 102423(a)(4)	1 2 3 4 5 6 7	102423 Personal Rights (a)(4) Each child receiving services from a family child care home shall have certain rights...regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to...infliction of pain, humiliation...This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Per licensee she will write statement on how the family child care home plans to protect the personal rights of children in care and send to LPA Dorsey by POC due date 03/09/22.
	8 9 10 11 12 13 14	Based on the evidence obtained during the investigation, it is determined that adult #3 exhibited inappropriate behavior and conduct in front of child #1, child #2, child #3 and child #4. This is a type A deficiency that poses an immediate Health, Safety and Personal Rights risk to children in care.	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: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

LIC9099 (FAS) - (06/04)

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Control Number 12-CC-20210909155852

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 198014759
	VISIT DATE: 03/02/2022

NARRATIVE

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Based on the evidence obtained including record reviews the preponderance of evidence has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, 102417(a) & 102423(a)) are being cited on the attached LIC 9099D.

The facility is being cited Type A deficiencies according to the California Code Title 22 Regulations and assessed an immediate civil penalty of $500.00.

Upon receipt of a Type A deficiency, licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to the parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a signed Acknowledgment of Licensing Report (LIC 9224) from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An exit interview was conducted with the licensee, a copy of this report, appeal right and Notice of Site Visit were provided to licensee Carlota Garcia.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

LIC9099 (FAS) - (06/04)

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