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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376610537
Report Date: 12/20/2021
Date Signed: 12/21/2021 07:22:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:BEEMON, LATASHA & JOHNSON, SAMUEL FCCFACILITY NUMBER:
376610537
ADMINISTRATOR:BEEMON, LATASHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 264-1149
CITY:SAN DIEGOSTATE: CAZIP CODE:
92113
CAPACITY:14CENSUS: 0DATE:
12/20/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Latasha BeemonTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Casey Gulley, conducted an unannounced case management inspection to cite supplemental deficiencies discovered during the course of an investigation. LPA also delivered two (2) amended reports during the inspection. Present in the home are co-licensee, Latasha Beemon, no children and no staff are present.

On 11/10/21, during an interview with LPA Casey Gulley, co-licensee, Beemon, admitted to falsely identifying a staff member during a previous inspection. On 09/02/21, during an inspection, co-licensee Beemon, falsely introduced staff member, Damonique Palmer to LPAs Gulley and Meier, as her adult daughter, Samantha Beemon. Co-licensee, Beemon allowed LPA Gulley to interview Palmer under the false pretense that LPA was conducting an interview with Samantha. On 12/15/21, during an interview with LPA Gulley, Samantha confirmed she had not been previously interviewed by LPA. LPA was unable to confirm Palmer’s actual identity, as co-licensee, Beemon, was either, unwilling or unable to provide Palmer’s personnel record and/or contact information.

California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

AB633 requires, upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. An Acknowledgment of Receipt of Licensing Reports (LIC 9224) must be signed and maintained in each child’s file immediately upon receipt from parent. Co-licensee was provided a copy of the LIC 9224 during the inspection.

An exit interview was conducted with the co-licensee and a copy of this report, along with Appeal Rights (LIC 9058 01/16), were provided. LPA provided a Notice of Site Visit (LIC 9213), which must remain posted for 30 days. LPA observed that the LIC 9213 was posted during the inspection.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey GulleyTELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: BEEMON, LATASHA & JOHNSON, SAMUEL FCC
FACILITY NUMBER: 376610537
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/21/2021
Section Cited

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1596.885 Conduct Inimical. Denial, suspension or revocation of license…The department may…suspend or revoke any license…upon any of the following....(c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. This requirement was not met as evidenced by:
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Based on interviews and co-licensee admission, co-licensee, Beemon engaged in inimical conduct by making false and/or misleading statements to LPA, which poses an immediate Health and Safety Risk to children in care.
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Co-licensee, Beemon was informed that a Non-Compliance Conference will be scheduled in the near future.

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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: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey GulleyTELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: BEEMON, LATASHA & JOHNSON, SAMUEL FCC
FACILITY NUMBER: 376610537
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2022
Section Cited

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102416.1(d) - Personnel Records. All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement was not met as evidence by:
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Based on interviews and records reviewed, co-licensee Beemon did not maintain a personnel records for multiple staff members at the facility, which poses a potential Health and Safety Risk to children in care.
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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: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey GulleyTELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3