198019446-6-18-2019-33-CC-BVON-BFYAC6-20190913000547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198019446
Report Date: 06/18/2019
Date Signed: 06/18/2019 11:29:37 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2019 and conducted by Evaluator Rita Ramos

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20190613161936

FACILITY NAME:	CUERVO & ESCAMILLA FAMILY CHILD CARE		FACILITY NUMBER:	198019446
ADMINISTRATOR:	G. CUERVO & L. ESCAMILLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 397-4038
CITY:	MONTEBELLO	STATE: CA	ZIP CODE:	90640
CAPACITY:	14	CENSUS: 3	DATE:	06/18/2019
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Lorena Valentina Escamilla		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Licensee failed to keep the home free of insects.

INVESTIGATION FINDINGS:

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THIS INSPECTION WAS CONDUCTED IN ENGLISH AND IN SPANISH
Licensing Program Analysts (LPAs) Rita Ramos and Denise Gibbs conducted an unannounced complaint inspection to the above facility. LPAs met with Lorena Valentina Escamilla, Licensee, who provided a tour of the facility. Also present during this inspection was Assistant, Gabriela Diosado, and Co-Licensee, Guillermo Cuervo. There were 3 children present upon arrival.

During the investigation LPAs interviewed staff, obtained a copy of the children's roster, and inspected the entire home both indoors and outdoors.

Information provided by the complainant indicates that the home has insects and that children and staff are getting bit by the insects.

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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 33-CC-20190613161936

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CUERVO & ESCAMILLA FAMILY CHILD CARE	FACILITY NUMBER: 198019446
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/18/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/02/2019 Section Cited CCR 102417(g)	1 2 3 4 5 6 7	Operation of a Family Child Care Home The home shall be free from defects or conditions which might endanger a child. This requirement is not met as evidenced by disclosures made by Licensee and staff that	1 2 3 4 5 6 7	Per Licensee, daily health checks will be conducted on the children and daily outdoor checks will be made before and after children play outisde.
	8 9 10 11 12 13 14	there are insects in the backyard of the facility. This poses a potential health and safety risk to children in care.	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: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 33-CC-20190613161936

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CUERVO & ESCAMILLA FAMILY CHILD CARE	FACILITY NUMBER: 198019446
	VISIT DATE: 06/18/2019

NARRATIVE

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Licensee Lorena Valentina Escamilla and Guillermo Escamilla both disclosed that they have had insects in the home, but they are outside in the outdoor yard. In addition, both Licensee's disclosed that there is a company that comes to the home monthly to spray the outdoor yard to prevent insect infestations. Licensee, Lorena Valentina Escamilla did disclose that Child #5 was recently bit by an insect and is continuing to have the yard sprayed.

Information provided by the staff indicated that there is insects observed outdoors and that children and staff are getting bit by the insects.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 Chapter 1 Operation of a Family Child Care Home 102417, is being cited on the attached deficiencies page.

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

LIC9099 (FAS) - (06/04)

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