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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191209401
Report Date: 09/15/2022
Date Signed: 09/15/2022 12:12:02 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/24/2022 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220524162223
FACILITY NAME:ZSIGMOND FAMILY DAY CAREFACILITY NUMBER:
191209401
ADMINISTRATOR:EDITH ZSIGMONDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 554-8813
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY:12CENSUS: 5DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:EDITH ZSIGMONDTIME COMPLETED:
12:25 PM
ALLEGATION(S):
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Criminal Record Clearance: Uncleared adult in the home.
Personal Right: Conduct of an adult in the home poses a risk to day care children.
INVESTIGATION FINDINGS:
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On 09/15/2022, Licensing Program Analyst (LPA) Loyce Phillips conducted an unannounced visit for the purpose of delivering findings for a complaint investigation conducted by IB. LPA met with Licensee, Edith Zsigmond and observed 5 children in care.

Based on the information obtained and interviews conducted, Robert Zsigmond was regularly present in the home and did not posses a criminal record clearance. At times during his presence in the home local law enforcement would be contacted to respond, therefore the allegations of Criminal Record Clearance and Personal Rights are substantiated. Substantiated findings mean that the allegation is valid because the preponderance of the evidence standard has been met.

LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
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 4
Control Number 30-CC-20220524162223
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ZSIGMOND FAMILY DAY CARE
FACILITY NUMBER: 191209401
VISIT DATE: 09/15/2022
NARRATIVE
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Type A citation is being issued and civil penalty is being assessed.

The Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.

In addition, a copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

An exit interview was conducted with Licensee Edith Zsigmond. A copy of this report and appeal rights were provided.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 30-CC-20220524162223
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZSIGMOND FAMILY DAY CARE
FACILITY NUMBER: 191209401
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2022
Section Cited
CCR
102370(d)(1)
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102370(d)(1) Criminal Record Clearance (d)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1)Obtain a California clearance or a criminal record exemption as required by the Department
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Licensee stated the uncleared adult no longer lives in the home and has a court order document prohibiting adult from entering the property.
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Based on interviews conducted, Uncleared Adult was present in the home without a criminal record clearance, which poses an immediate health, safety or personal rights risk to persons 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.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/24/2022 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220524162223

FACILITY NAME:ZSIGMOND FAMILY DAY CAREFACILITY NUMBER:
191209401
ADMINISTRATOR:EDITH ZSIGMONDFACILITY TYPE:
810
ADDRESS:6613 BELLINGHAMTELEPHONE:
(818) 554-8813
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY:12CENSUS: 5DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:EDITH ZSIGMONDTIME COMPLETED:
12:25 PM
ALLEGATION(S):
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Personal Rights: Illegal drugs in the facility.
INVESTIGATION FINDINGS:
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**This is an amended report.**

On 09/15/2022, Licensing Program Analyst (LPA) Loyce Phillips conducted an unannounced visit for the purpose of delivering findings for a complaint investigation conducted by IB. LPA met with Licensee, Edith Zsigmond and observed 5 children in care.

Based upon evidence obtained throughout the course of this investigation, including law enforcement reports and interview conducted by Investigations Branch Investigator, Jose Santana, there is insufficient evidence to establish the presence of drugs in the facility. Therefore, the allegation of Personal Rights is deemed unsubstantiated.

A copy of this report and appeal rights will be provided to Licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4