198019339-8-1-2019-54-CC-BVON-BHMTKH-20191105134751

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198019339
Report Date: 08/01/2019
Date Signed: 08/01/2019 10:21:03 AM

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
07/25/2019 and conducted by Evaluator Armando J Lucero

COMPLAINT CONTROL NUMBER: 54-CC-20190725123145

FACILITY NAME:	SANTOS FAMILY CHILD CARE		FACILITY NUMBER:	198019339
ADMINISTRATOR:	BENILDA SANTOS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 453-6149
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	14	CENSUS: 1	DATE:	08/01/2019
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Benilda Santos, Licensee		TIME COMPLETED:	10:40 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Uncleared adult in the home

INVESTIGATION FINDINGS:

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

An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) A. Lucero regarding the allegation above. LPA met with Licensee Benilda Santos who guided LPA on a tour of the indoors and outdoors of the facility.

Complaint alleges uncleared adult in the home. Upon a tour of the home, LPA observed an individual by the name of Yadira Santos in the converted garage. Yadira Santos stated to LPA that she was visiting and has been at the facility for 15 days. Licensee stated that Yadira Santos was her daughter and was visiting. Licensee stated that Yadira Santos arrived by airplane, but could not provide proof of flight information.

LPA observed the room where Yadira Santos to be staying in was a garage that was converted into a bedroom with a small dining area. LPA also observed four minors sleeping in bunk beds that both Licensee and Yadira Santos stated that they were Yadira's children. LPA did not observe luggage in the room.
Report Continues on Next Page

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

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

LIC9099 (FAS) - (06/04)

Page: 4 of 6

Control Number 54-CC-20190725123145

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: SANTOS FAMILY CHILD CARE	FACILITY NUMBER: 198019339
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/01/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 08/01/2019 Section Cited CCR 102370(d)(1)	1 2 3 4 5 6 7	Criminal Record Clearance All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department.	1 2 3 4 5 6 7	Licensee stated that she will get Yadira Santos finger printed and will have Claudia Ramirez vacate the premises. A POC visit will be conducted.
	8 9 10 11 12 13 14	The requirement is not met as evidenced by: LPA determined through a tour of the home that Yadira Santos was present in the home and has been present for 15 days; and, Claudia Ramirez was present in the home and has been living in the home for four days. This is an immediate risk to children in care. Civil Penalty of $900.00 assessed.	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: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

LIC9099 (FAS) - (06/04)

Page: 6 of 6

Control Number 54-CC-20190725123145

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: SANTOS FAMILY CHILD CARE	FACILITY NUMBER: 198019339
	VISIT DATE: 08/01/2019

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

LPA also determined that an individual by the name of Claudia Ramirez is renting a room from Licensee. Claudia Ramirez stated that she has been living at the facility for four days. LPA determined that Claudia Ramirez is not finger print cleared. Licensee stated that the reason why Claudia Ramirez has yet to get her finger prints is because Licensee does not expect Claudia Ramirez to stay more than a month. LPA reminded Licensee that all individuals living in the home must be finger print cleared. Licensee stated that she understood that adults living in the home need to be finger print cleared. This is an immediate risk to children in care. A civil penalty of $900.00 was assessed on this day for having two adult. LPA obtained Declaration Forms.

Based on the LPA's observations, interviews concluded and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22 102370(d)(1) Criminal Record Clearance, is being cited on the attached LIC 9099-D.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). Acknowledgement of Receipt (LIC 9224 form) must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) and (SP) Form during this visit.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview conducted with the Licensee, during which appeal rights were given and explained. A copy of the Appeal Rights (SP) (LIC 9058 01/16) was provided as well as LIC 9163 (SP). The Licensee’s signature on this report acknowledges receipt of rights.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Armando J Lucero	TELEPHONE: (323) 981-3435
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

LIC9099 (FAS) - (06/04)

Page: 5 of 6