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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 192001020
Report Date: 12/15/2022
Date Signed: 12/15/2022 05:15:57 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/27/2022 and conducted by Evaluator Keyona Scott
COMPLAINT CONTROL NUMBER: 30-CC-20220927094339
FACILITY NAME:HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
192001020
ADMINISTRATOR:HERNANDEZ, JO A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 706-7674
CITY:INGLEWOODSTATE: CAZIP CODE:
90301
CAPACITY:14CENSUS: 4DATE:
12/15/2022
UNANNOUNCEDTIME BEGAN:
02:38 PM
MET WITH:JoAnn Hernandez- LicenseeTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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PHYSICAL PLANT- facility has animal feces/urine on floor/carpet

PHYSICAL PLANT- facility has roaches

PHYSICAL PLANT- facility has mice
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Keyona Scott, conducted an unannounced Complaint Investigation to the Family Child Care home, on 12/15/2022, regarding Complaint Control # 30-CC-20220927094339, for purpose of conducting complaint investigation and delivering findings. LPA met with Licensee, Jo A. Hernandez at 2:47 PM. Present during today's investigation were Licensee and four children which includes one infant. All Adults present, working and/or volunteering in the home have a criminal record clearance or exemption.

During today's inspection, LPA conducted facility observation and interviews.

It was alleged that facility has animal feces/urine on floor/carpet, facility has roaches and facility has mice. Based on investigation, observation and interviews conducted, no disclosures were made and none of the allegations were observed. Per interview, house cleaning is maintained daily and pet pads are removed immediately once soiled; therefore, the allegations of PHYSICAL PLANT, facility has animal feces/urine on floor/carpet, facility has roaches and facility has mice, is UNSUBSTANTIATED, PAGE 1
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Keyona Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
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 2
Control Number 30-CC-20220927094339
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 192001020
VISIT DATE: 12/15/2022
NARRATIVE
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meaning although the allegation may have happened or are valid, the preponderance of the evidence standard has not been met.

There were no deficiencies cited during today's inspection on 12/15/2022.

The following was thoroughly discussed with Licensee:

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.



LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee JoAnn Hernandez
PAGE 2.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Keyona Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2