203804609-1-28-2020-04-CC-DMAA-BLT2VW-20200214164433

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 203804609
Report Date: 01/28/2020
Date Signed: 01/28/2020 01:18:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/27/2020 and conducted by Evaluator Juvenal Moctezuma

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20200127160918

FACILITY NAME:	COSIO FAMILY CHILD CARE		FACILITY NUMBER:	203804609
ADMINISTRATOR:	COSIO, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 673-1453
CITY:	MADERA	STATE: CA	ZIP CODE:	93638
CAPACITY:	14	CENSUS: 6	DATE:	01/28/2020
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Maria Cosio		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

1. Licensee operating over capacity

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced inspection to initiate a complaint investigation. LPA met with licensee, Maria Cosio and husband and discussed the purpose of the inspection. A tour of the home was conducted both inside and outside and census was taken.

During the course of the investigation, LPA interviewed and obtained information from Reporting Party and interviewed licensee. During today's inspection, the licensee acknowledged that she was operating over her licensed capacity on 01/14/2020. Licensee stated that she was caring for more than 8 children but assumed that she could use Adult #1 as her assistant. LPA reminded licensee that during the Case Management that was conducted on 12/11/2019, she stated that her only assistants were Assistant #1, #2, and #3. Today licensee stated, that she didn't know she could not use Adult #1 as her assistant in case her regular assistants were not available. LPA explained that if she wishes to use anyone else as an assistant, they need to have the proper documentation to be qualified as her assistant and Adult #1 does not. Licensee understood and apologized and stated that she will follow her license capacity from now on.
Report Continued Onto LIC 9099-C

Substantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

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

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 04-CC-20200127160918

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: COSIO FAMILY CHILD CARE	FACILITY NUMBER: 203804609
	VISIT DATE: 01/28/2020

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

Based on interviews and documentation obtained during the investigation, it was determined that there is a preponderance of the evidence to prove that this facility was operating over capacity; therefore, the allegation is SUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, One Type A deficiency was cited. A copy of the report, appeal rights, and a Notice of Site Visit was provided to Licensee.

In exit interview the licensee was advised of appeals rights and was provided with Appeals Rights. Licensee was also advised that this report with the Type A Deficiency must be posted for 30 days where parents may easily view and filed in facility file for public review for 3 years.

Licensee is advised to make this licensing report accessible to the public and to provide copies of this licensing report and 9099-D with Type A citation to parents/legal guardians of children in care and to parents/legal guardians of children newly enrolled at the facility during the next 12 months. Licensee is to keep verification of receipt (LIC 9224) in each child's file at the facility. An LIC 9224 and Assembly Bill 633 fact sheet was provided to licensee on this date.

This report was translated in Spanish by LPA Moctezuma.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 04-CC-20200127160918

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: COSIO FAMILY CHILD CARE	FACILITY NUMBER: 203804609
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/28/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/31/2020 Section Cited CCR 102416.5(a)	1 2 3 4 5 6 7	The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement is not met as evidenced by interview of	1 2 3 4 5 6 7	Licensee agreed to start a sign in/ sign out sheet to make sure she does not go over capacity when she doesn't have an assistant. Licensee shall submit letter/posting to Community Care Licensing by 01/31/2020. Licensee agrees view How Many Children Can Attend A Family Child Care Home Video at:
	8 9 10 11 12 13 14	licensee admitting to caring for 9 children without a qualified assistant. This poses as a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14	https://ccld.childcarevideos.org/ by 01/31/2020. Licensee agreed to submit printable transcript of child care videos with date and time and sent via mail to Community Care Licensing by 01/31/2020.
	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: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 3