198019677-1-25-2021-54-CC-BVON-BYAT6U-20210216132741

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198019677
Report Date: 01/25/2021
Date Signed: 01/25/2021 03:23:40 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
10/26/2020 and conducted by Evaluator Rita Ramos

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20201026153148

FACILITY NAME:	MARTINEZ FAMILY CHILD CARE		FACILITY NUMBER:	198019677
ADMINISTRATOR:	LORENA MARTINEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 427-4708
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90011
CAPACITY:	14	CENSUS: 4	DATE:	01/25/2021
		ANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Lorena Martinez, Licensee		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Licensee allowed minor to provide care and supervision to day-care children.

INVESTIGATION FINDINGS:

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THIS INSPECTION WAS CONDUCTED IN SPANISH AND ENGLISH
Due to COVID-19 and guidelines of social distancing, this inspection was conducted virtually via FaceTime and in Spanish. Licensing Program Analyst (LPA) Rita Ramos met with Lorena Martinez, Licensee, who guided analyst on a tour of the facility. There were 4 children present.

LPA delivered findings during the tele-inspection for the above allegation.

During investigation LPA conducted interviews, obtained a copy of the children's roster, and obtained copies of documentation.

Information provided by the reporting party indicates that Licensee allowed minor to provide care and supervision to day care children.
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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
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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Control Number 54-CC-20201026153148

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: MARTINEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019677
	VISIT DATE: 01/25/2021

NARRATIVE

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Licensee was interviewed during this investigation.

When interviewing parents, Parent #4 indicated that Child #1 was left alone to supervise children while Licensee went to the store. Parent #5 indicated that they observed Child #1 alone providing care to children while Licensee picked up other children from school. Parent #3 indicated that Child #1 assists Licensee with providing care and supervision to day care children.

Child #7 disclosed that Child #1 is left alone to provide care and supervision to day care children. Child #6 indicated that Licensee left Child #1 alone to provide care and supervision to day care children.

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 102417(a) Operation of a Family Child Care is being cited on the attached deficiencies page.

An immediate civil penalty of $500 is being assessed.

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). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee.

An exit interview was conducted by LPA Rita Ramos with Lorena Martinez, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. This report was sent via email to Applicant and an electronic read receipt confirms receiving the report. The representative was provided with the Monterey Park South West office and agrees to send the signed originals by mail.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
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

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 54-CC-20201026153148

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: MARTINEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019677
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/25/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/25/2021 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	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. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care and supervise the	1 2 3 4 5 6 7	Per Licensee, they will not leave a minor alone to supervise children in care and will submit a written declaration indicating that they will no longer do so by POC due date of 01/26/21
	8 9 10 11 12 13 14	children during his/her absence. This requirement is not met as evidenced by disclosures made from Parent #3, #4, #5 and Child #6 and #7 indicating that Child #1 provides care and supervision to childcare children. This poses an immediate 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: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita Ramos	TELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2021

LIC9099 (FAS) - (06/04)

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