198019823-5-8-2019-33-CC-TCON-BC92LC-20190516172920

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198019823
Report Date: 05/08/2019
Date Signed: 05/08/2019 10:49:20 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
02/14/2019 and conducted by Evaluator Warren Birks

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20190214123915

FACILITY NAME:	SMITH FAMILY CHILD CARE		FACILITY NUMBER:	198019823
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	05/08/2019
		UNANNOUNCED	TIME BEGAN:	08:38 AM
MET WITH:	Sheriah Smith		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Licensee was absent from facility for extended period of time

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Warren Birks conducted an unnounced complaint inspection to investigate the above allegation. LPA met with Licensee Sheriah Smith who was caring for three infants. A cleared assistant and cleared adult resident was also available.

LPA met with the Licensee on two separate unnanounced visits. Licensee Smith indicated she sometimes may leave the facility for two hours twice a week (occassionally during the hours of 4pm-6pm for an outside child care training. LPA received additional information that the allegation was a miscommunication to Licensing and the Licensee was not observed to be away from the facility 80% of the time. Based on interviews, the above allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation did or did not occur, therefore these allegation are unsubstantiated. 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 Licensee Sheria Smith.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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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