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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197416878
Report Date: 08/15/2023
Date Signed: 08/18/2023 03:30:04 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
05/23/2023 and conducted by Evaluator Judy Laureano
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230523131614
FACILITY NAME:MINWALLA FAMILY CHILD CAREFACILITY NUMBER:
197416878
ADMINISTRATOR:MINWALLA, SHAMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 801-8155
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY:14CENSUS: 5DATE:
08/15/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Shama MinwallaTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Neglect/Lack of Supervision: Provider left daycare child outside for a period of time.
INVESTIGATION FINDINGS:
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*amended report to reflect correct date*
On 8/15/2023 Licensing Program Analyst (LPA) Judy Laureano conducted a complaint inspection to deliver findings regarding the above-mentioned allegation. LPA met with licensee Shama Minwalla and explained the purpose of the inspection. There were 5 children an2 staff members providing care and supervision.

On 5/25/2023 Licensing Program (LPA) Judy Laureano arrived at 1609 Carmona Avenue, Los Angeles, CA 90019 for the purpose of investigating the above-mentioned allegation. Upon arrival, LPA met with Shama Minwalla and Karina Castro and discussed the purpose of the visit. LPA toured the facility and observed 3 children in care and 2 staff providing care and supervision. LPA received and reviewed the children’s roster. LPA initiated interviews with licensee, assistant, and children.

On 8/2/2023 LPA completed interviews of all relevant parties.
Based on the information received, LPA’s observations and licensee’s statement, the
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
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 58-CC-20230523131614
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: MINWALLA FAMILY CHILD CARE
FACILITY NUMBER: 197416878
VISIT DATE: 08/15/2023
NARRATIVE
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allegation of provider leaving daycare child outside for a period of time is substantiated.
Substantiated findings mean that the allegation is valid because the preponderance of the evidence standard has been met. Deficiencies are being cited accordance to Title 22 of the California Code of Regulations and/or Health & Safety Codes.

Exit interview was conducted and a copy of the report was provided.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 58-CC-20230523131614
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: MINWALLA FAMILY CHILD CARE
FACILITY NUMBER: 197416878
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2023
Section Cited
CCR
102417(a)
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102417-Operation of Family Child Care
(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times…
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Licensee agrees to submit to LPA a plan when children do not nap. Licensee also agrees to view and write a short statment of what video covers and submit to LPA by 8/24/2023
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This requierment is not met as evidenced by: Based on LPA's record review and Licensee’s statement, child was left unsupervised for a period of time on 5/19/2023.
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Supervising Children in Family Child Care
https://ccld.childcarevideos.org/family-child-care-providers/supervising-children-in-family-child-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: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC9099 (FAS) - (06/04)
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