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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198014905
Report Date: 06/16/2022
Date Signed: 06/16/2022 11:08:18 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
04/14/2022 and conducted by Evaluator Elka Chavez
COMPLAINT CONTROL NUMBER: 54-CC-20220414085826
FACILITY NAME:CARDONA FAMILY CHILD CAREFACILITY NUMBER:
198014905
ADMINISTRATOR:JUAN CARDONAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 587-8766
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY:14CENSUS: 6DATE:
06/16/2022
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:TIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Facility is operating over the capacity.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elka Chavez conducted an unannounced complaint inspection on this date. LPA met with Licensee, Juan Cardona who guided LPA on a tour of the facility indoors and outdoors. There were 6 children present during today's inspection.

During the course of the investigation LPA contacted the reporting party, in an attempt to request documentation regarding the above allegation. To date the requested documentation has not been received. During the course of the investigation, interviews were conducted with staff and parents and no disclosures were made. During the interview with the licensee he disclosed that 16 children were under his care from 3/22/22 through 3/25/22 from approximately 2:30pm to 5:30pm. LPA interviewed staff #1 and no disclosures were made.

Based on LPA’s interviews which were conducted, the preponderance of the evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED.California Code of Regulations, (Title
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
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-20220414085826
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/16/2022
Section Cited
CCR
102416.5(a)
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102416.5(a) Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement was not
met as evidenced by

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Licensee stated that children were disenrolled and are now attending a different day care. Licensee stated that he spoke to the parents of children and asked them to run any errands before work and to make sure children are being picked up at the time they are scheduled.Licensee is also not accepting new enrollees.
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Based on interview, the licensee stated that he cared for 2 additional children from 3/22/22 through 3/25/22 from approximately 130-530pm. Licensee has a license for 14 and cared for 16 children. Licensee did not comply with the section cited above in children in care which posed a potential health, safety or personal rights risk to persons in care.
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06/16/2022
Section Cited
CCR
102371(a)
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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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20220414085826
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
VISIT DATE: 06/16/2022
NARRATIVE
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California Code of Regulations, (Title 22, Division 12 & Chapter 1 (FCC) (1 DCC) number) are being cited on the attached LIC9099D

Exit interview was conducted with Licensee, Juan Cardona. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3