198016431-9-16-2021-54-CC-KCHS-C7APN2-20210928112714

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198016431
Report Date: 09/16/2021
Date Signed: 09/16/2021 12:11:22 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
06/24/2021 and conducted by Evaluator Elka Chavez

COMPLAINT CONTROL NUMBER: 54-CC-20210624145816

FACILITY NAME:	GUTIERREZ FAMILY CHILD CARE		FACILITY NUMBER:	198016431
ADMINISTRATOR:	GUTIERREZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 639-4548
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	14	CENSUS: 5	DATE:	09/16/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Maria Guterrez		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Child wandered away

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elka Chavez, conducted an unannounced inspection in Spanish at the facility listed above to conclude the above pending allegation. LPA met with licensee, Maria Gutierrez.
Information provided by reporting party indicates that child #4 was found on Virginia Avenue approximately 650 feet away from the facility.

Licensee disclosed that the children were taken to the front yard to make bubbles at around 12:40 pm. Licensee stated that she noticed the child was missing at 1:00 pm. Licensee stated the child was returned to the facility by a neighbor at around 1:05 pm.

Staff #1 disclosed she noticed the child went missing at around 12:50 pm. Children were taken to the front yard between 12:35 pm and 12:40 pm.

Child #1, #2 and #3 disclosed observing the child being returned by a neighbor to the facility.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

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 3

Control Number 54-CC-20210624145816

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: GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198016431
	VISIT DATE: 09/16/2021

NARRATIVE

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Based on LPAs observations of the declarations obtained and 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 22, Division 12 & Chapter 1 (FCC) 102417(a) are being cited on the attached LIC9099D.

Exit interview was conducted with Licensee, Maria Gutierrez, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights in Spanish.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 54-CC-20210624145816

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: GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198016431
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/16/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/16/2021 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	The Licensee stated that the chldren no longer use the unfenced front yard. Licensee stated that she will make sure to have direct supervision.
	8 9 10 11 12 13 14	Based on interviews conducted, of the seven children in care and under the supervision of the Licensee and their assistant one child was able to wander away from the facility and not known for approximately 15 minutes. The child was able to wonder 655 feet from the facility and was returned by a neighbor. This poses an immediate health, safety, or personal rights risk to persons in care. An immediate civil penalty in the amount of $500 is being accessed.	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: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021

LIC9099 (FAS) - (06/04)

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