334842136-12-1-2021-10-CC-CMAZ-C9WSF6-20211221124949

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334842136
Report Date: 12/01/2021
Date Signed: 12/01/2021 03:17:45 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 STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/14/2021 and conducted by Evaluator Sumayya Habeebulla

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20211014111408

FACILITY NAME:	KELLEY FAMILLY CHILD CARE		FACILITY NUMBER:	334842136
ADMINISTRATOR:	MONICA KELLEY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 657-9491
CITY:	PERRIS	STATE: CA	ZIP CODE:	92571
CAPACITY:	14	CENSUS: 5	DATE:	12/01/2021
		UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Madison Rodriguez		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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- Facility is over capacity.
- An adult was living at the facility with no clearance.
- Adults argue in front of the daycare children.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Sumayya Habeebulla, Ana Noble, and Linda Alvaraz arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 10/21/21. LPAs met with Madison Rodriguez and discussed the above allegations. LPAs interviewed one of the oldest child in care during this visit.

On 10/21/21 LPA Habeebulla conducted interviews with the Licensee, and daughter of the Licensee, all of whom are pertinent to this investigation. Along with interviews, the investigation revealed that:

See LIC9099-C for continuation of this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

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 10-CC-20211014111408

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KELLEY FAMILLY CHILD CARE	FACILITY NUMBER: 334842136
	VISIT DATE: 12/01/2021

NARRATIVE

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There is an allegation that the facility was operating over capacity. During the Initial visit on 10/21/21 LPA observed three children in care, a three-year-old was napping and the other two were under the age of 1. The ages were verified as per the roster provided by the Licensee.
During today’s inspection LPAs observed 5 children currently at the facility and 18 enrolled as per the roster, per Licensee she does not have all of them at the same time. Licensee denies operating over capacity.

Based on the information obtained, LPAs cannot determine if the facility was operating over capacity during the reported time frame. From the information received by interviews, and the facility roster the above allegation cannot be verified.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED

The second allegation is that there is an uncleared adult living at the facility. Based on interviews and information received the only adults who have lived at the facility are the Licensee, and her adult daughter and son who are all cleared and associated with the facility. Licensee has an assistant who is at the facility from 10 AM to 4 PM Monday through Friday and is also cleared and associated with the facility. Based on the information obtained through interviews, record reviews and observations, LPAs cannot determine if there has been an uncleared adult at the facility and therefore the above allegation cannot be verified.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

The third allegation is that adults argued in front of the children. Based on the information obtained through interviews, LPAs cannot determine if there have been arguments in front of the day care children. From the information received by interviews, the above allegation cannot be verified.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED

An exit interview was conducted, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC9099 (FAS) - (06/04)

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