334818524-5-3-2019-09-CC-KWIS-BCCV8S-20190520161313

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334818524
Report Date: 05/03/2019
Date Signed: 05/03/2019 02:35:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/09/2019 and conducted by Evaluator Taadhimeka Zeigler

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20190409131711

FACILITY NAME:	MACEDO FAMILY CHILD CARE		FACILITY NUMBER:	334818524
ADMINISTRATOR:	LILLY MACEDO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 678-7217
CITY:	LAKE ELSINORE	STATE: CA	ZIP CODE:	92530
CAPACITY:	14	CENSUS: 12	DATE:	05/03/2019
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Lily Macedo		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Unsafe driver conducting school drop off and pick-up
License number not listed on facility van

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Taadhimeka Zeigler made an unannounced visit to this facility for the purpose of completing a complaint investigation, that was initiated April 12, 2019. LPA Zeigler was greeted by Licensee, Lily Macedo. The facility was toured, and a census was taken.

The investigation included staff and children interviews, a review of documentation, and observations.

Regarding the allegation that an unsafe driver is conducting school drop off and pick-up, it was confirmed during interviews that staff had been approached regarding following safe practices during drop off/pick up times by school personnel.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Taadhimeka Zeigler	TELEPHONE: (951) 680-6745
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

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 09-CC-20190409131711

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MACEDO FAMILY CHILD CARE	FACILITY NUMBER: 334818524
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/06/2019 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	PERSONAL RIGHTS: Each child receiving services from a family child care home shall receive safe, healthful, and comfortable accommodations, furnishings, and equipment.	1 2 3 4 5 6 7	The licensee will submit a written statement acknowledging the importance of following safe practices, at all times, when transporting children in licensees care.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on interviews, the licensee does not always follow safe practices during drop off/pick up of children in care.	8 9 10 11 12 13 14
Type B 06/03/2019 Section Cited CCR 102359(a)	1 2 3 4 5 6 7	ADVERTISEMENT AND LICENSE NUMBER: Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The licensee removed the advertisement on the facility van. Licensee shall send to CCL a written statement acknowledging that any advertisement for the child care must include the facility license number.
	8 9 10 11 12 13 14	LPA observed that the licensee does not indicate the license facility number on the facility’s transportation vehicle which displays the facility name and telephone number.	8 9 10 11 12 13 14

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: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Taadhimeka Zeigler	TELEPHONE: (951) 680-6745
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

LIC9099 (FAS) - (06/04)

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Control Number 09-CC-20190409131711

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MACEDO FAMILY CHILD CARE	FACILITY NUMBER: 334818524
	VISIT DATE: 05/03/2019

NARRATIVE

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It was also confirmed that while dropping off a child, the licensee bypassed the right drop off lane and pulled in front of another vehicle that was attempting to exit the right drop off lane. The maneuver caused the vehicle that was trying to exit the drop off lane to be blocked in by licensee until the children exited the licensee’s vehicle and the licensee moved.

Regarding the allegation that the license number is not listed on the facility van, it was observed that the licensee is advertising the child care on the facility transportation vehicle. The name of the facility and the telephone number are displayed. The advertising does not contain the facility’s license number.

Based upon LPAs observations and information gathered through interviews, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, are being cited on the attached LIC 9099D.

An exit interview was conducted with Lily Macedo, a Plan of Correction (POC) was discussed, and Appeal Rights were explained. A copy of this report as well as a copy of the Appeal Rights were provided.

A Notice of Site Visit was posted and must remain posted for 30 days for public review.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Taadhimeka Zeigler	TELEPHONE: (951) 680-6745
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

LIC9099 (FAS) - (06/04)

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