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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376627090
Report Date: 10/19/2021
Date Signed: 10/20/2021 07:38:03 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/17/2021 and conducted by Evaluator Adrian L Mangina
COMPLAINT CONTROL NUMBER: 51-CC-20210917162049
FACILITY NAME:POLUS, RITA FAMILY CHILD CAREFACILITY NUMBER:
376627090
ADMINISTRATOR:RITA POLUSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 715-7898
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:14CENSUS: 9DATE:
10/19/2021
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Rita PolusTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Licensee is operating over capacity.
INVESTIGATION FINDINGS:
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On 10/18/21 at 4:00 PM Licensing Program Analyst LPA conducted an unannounced inspection at the home. The purpose of the visit was to obtain Licensee's children's schedule. At arrival LPA observed that Licensee did not have an assitant present in the home, and was caring for a total of 9 children, including Licensee's own two children.under the age of ten years. Licensee stated that her assitant was at an appointment and that her father in law,Youhanna Marrogi, was present in the home but was not actively assiting with th caring of the children.

It was alleged that Licensee was operating over capacity. During the investigation LPA reviewed documents and conducted surveillance which confirmed that Licensee is operating over capacity. The allegation is valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12, Chapter 1, Section 102416.5(e)) the deficiency is being cited on the attached LIC 9099D.
(Continued on LIC9099 page 2)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
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 51-CC-20210917162049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: POLUS, RITA FAMILY CHILD CARE
FACILITY NUMBER: 376627090
VISIT DATE: 10/19/2021
NARRATIVE
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(LIC9099 page 2)

An exit interview was conducted with the Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) along with a copy of this the report (LIC9009) their signature on this form acknowledges receipt of these rights. LPA observed LIC 9213 (Notice of Site visit) was posted during today's visit. Notice of Site Visit must remain posted for 30 days.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 51-CC-20210917162049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: POLUS, RITA FAMILY CHILD CARE
FACILITY NUMBER: 376627090
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/02/2021
Section Cited
CCR
102416.5(e)
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Staffing Ratio and Capacity: If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home...

This requirement was not me as evidenced by:
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Licensee called a parent and sent two children home within 15 minutes. Licensee states that she will read and summarize the staffing and ratio regulation (102416.5) and Personnel Requirements (102416) provide summaries to LPA no later than close of business 11/2/21.
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Licensee did not have a qualified assistant present and was caring for 9 children, including two of Licensee's own children under 10 years old, 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: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3