198017228-1-25-2021-54-CC-TCON-BXUP4Q-20210202095931

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198017228
Report Date: 01/25/2021
Date Signed: 01/25/2021 01:07:24 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
10/30/2020 and conducted by Evaluator Dayna Chambers

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20201030155405

FACILITY NAME:	NICHOLAS FAMILY CHILD CARE		FACILITY NUMBER:	198017228
ADMINISTRATOR:	NICHOLAS, SHAMEKA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 788-0855
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 13	DATE:	01/25/2021
		UNANNOUNCED	TIME BEGAN:	12:29 PM
MET WITH:	Shameka Nicholas, Licensee SOE COVID 19		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility has Vermin
Facility is not kept clean
Staff did not ensure that child was supervised appropriately

INVESTIGATION FINDINGS:

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Due to COVID 19 SOE: the LPA was not in the home. January 25, 2021, 1:00pm Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced complaint inspection to deliver findings for the above allegations. LPA met with Shameka Nicholas, licensee, who assisted with the inspection. There were 13 children in care. A copy of this report will be emailed to licensee at: meeksqueak@gmail.com and the return receipt and acknowledgment from licensee will serve as the signature.

During this investigation, LPA interviewed parents and staff. There were no witnesses or disclosures regarding the above allegations. LPA obtained documents to assist with the investigation.

Based on interviews conducted, the above allegations are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore these allegations are unsubstantiated. Due to COVID 19 SOE, exit interview was not conducted with Shameka Nicholas, Licensee.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2021

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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