198019446-7-22-2022-33-CC-BVON-CGRS2S-20220728133001

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198019446
Report Date: 07/22/2022
Date Signed: 07/22/2022 02:19:29 PM

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 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
05/03/2022 and conducted by Evaluator Mireya Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20220503164555

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: 5	DATE:	07/22/2022
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Licensee Lorena Valentina Escamilla		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Licensee is not providing adequate supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mireya García arrived unannounced at the facility for the purpose of conducting a complaint investigation regarding the allegation listed above. Due to COVID- 19 precautionary measures were taken, and licensing staff present during the inspection wore appropriate personal protective equipment. LPA met with L. Valentina Escamilla, who guided LPA on a tour of the facility. There were (5) children observed to be present at the facility during this inspection. The Licensee’s Assistant, Gabriela Diosado was also present during this visit. Licensee's husband Guillermo Cuervo later arrived.

Information provided by the complainant alleges that Licensee is not providing adequate supervision.

During this investigation, LPA Garcia obtained a copy of Children’s rosters dated 04/21/2022 and conducted interviews with Licensee, daycare staff, and daycare parents.
THE REPORT CONTINUES ON NEXT PAGE 1 OF 2.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

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-20220503164555

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: 07/22/2022

NARRATIVE

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Pertaining to the allegation that the Licensee is not providing adequate supervision, interviews conducted with staff determined that an incident occurred in May of 2022 where child #4 was injured while in care. Statements from staff confirm that incident took place at the facility. Staff providing care and supervision disclosed being present however, statements from the staff that observed child #4 when child #4 was injured were inconsistent and neither staff present saw the incident occur. During interviews with the Licensee, it was disclosed that children with challenging behaviors are fighting daily which results in children hitting each other, the licensee does not have a plan in place for children fighting and hitting each other. This poses a potential health and safety risk to children in care. The licensee also disclosed that she has a small business that she is running in the home. The licensee states that she does this business during naptime when children are sleeping. Declaration obtained.

Based on LPA’s interviews which were conducted, and record reviews, 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, the following deficiency is being cited (see attached 9099D).
Notice of Site visit was provided to the licensee and must remain posted for 30 days.

An exit interview was conducted, and the report was reviewed with Licensee, Lorena Valentina Escamilla.
END OF REPORT: PAGE 2 OF 2

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20220503164555

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: 07/22/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/05/2022 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	102423(a)(2): Personal Rights-(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Per Licensee, she and her assistant will seek training with the local R & R regarding dealing with children with challenging behavior. Licensee will discuss the responsibility for providing care and supervision with staff to ensure staff use active supervision strategies and are following Title 22 Regulations. The licensee will submit a written plan for working with children with challenging behaviors and how she will ensure supervision is provided to children in care. The licensee states that she will submit the plan by 08/05/2022.
	8 9 10 11 12 13 14	Based on LPA’s interviews, staff confirmed that an incident took place in May of 2022, where child #4 was injured while in care. Staff providing care and supervision disclosed being present however, statements from the staff who observed child #4 when child #4 was injured were inconsistent and neither staff present saw the incident occur. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
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	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: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

LIC9099 (FAS) - (06/04)

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