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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376628181
Report Date: 02/25/2020
Date Signed: 02/25/2020 01:39:13 PM



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
01/23/2020 and conducted by Evaluator Elizabeth Rivera
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20200123085134
FACILITY NAME:CHAPA, CLAUDIA FAMILY CHILD CAREFACILITY NUMBER:
376628181
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
02/25/2020
UNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Claudia Chapa, Licensee TIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Unclear adult in facility
INVESTIGATION FINDINGS:
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On 02/25/20 at 12:05 p.m. Licensing Program Analyst (LPA) Elizabeth Rivera conducted an unannounced complaint inspection for the purpose of delivering the finding for the above allegation. Upon arrival LPA met with Licensee, Claudia Chapa. Present was the Licensee with 5 children including 1 infant. Appropriate ratio and capacity were observed.

Based upon information gathered through observations and interviews, the preponderance of evidence standard has been met indicating Licensee had an unclear residing in the facility. During the investigation and interview with Licensee, she admitted her son had turned 18 years and had not obtained fingerprint clearance due to being out of state but returned to his residence on 1/21/20, therefore the above allegation is Substantiated. Deficiency is cited on LIC 9099D and a civil penalty of $500.00.

The Notice of Site Visit was provided, and LPA observed posting. Licensee is advised it must remain posted for 30 days.

An exit interview was conducted with Licensee. A printed copy of this report as well as a printed copy of the appeal rights (1/16) was provided and reviewed with Licensee at the conclusion of the visit. Signature at the bottom of this report confirms receipt.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Elizabeth RiveraTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
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 2
Control Number 51-CC-20200123085134
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: CHAPA, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 376628181
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/26/2020
Section Cited
CCR
102370(d)(1)
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(d) All individuals subject to a criminal record...shall...(1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by:
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Licensee will submit proof of fingerprints to LPA within 24 hours.
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Based on LPA's observation and Licensee's statement stating son turned 18 and had not submitted fingerprints to CCLD. Licensee did not have son submit fingerprints after his 18 birthday. This poses an immediate 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: Elizabeth RiveraTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2