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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197492937
Report Date: 03/23/2023
Date Signed: 03/23/2023 10:48:43 AM

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
02/10/2023 and conducted by Evaluator Shandra Powell
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20230210160618
FACILITY NAME:MACK FAMILY CHILD CAREFACILITY NUMBER:
197492937
ADMINISTRATOR:MACK, LAKEISHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 331-5995
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:14CENSUS: 10DATE:
03/23/2023
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:LaKeisha Mack, LicenseeTIME COMPLETED:
11:03 AM
ALLEGATION(S):
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9
Criminal Record Clearance - Uncleared adult living on the premises.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Shandra Powell conducted an unannounced complaint visit for the purpose of concluding the investigation for the above allegation. LPA met LaKeisha Mack, licensee. Licensee gave LPA a tour of the home. LPA observed 10 children in care in the main child care room. (1 infant, 5 preschoolers and 4 school age).

Based upon the evidence obtained through the course of reviewing documentations and interviews, there is insufficient evidence to support or disprove that Uncleared adult is living in the home. However evidence proves the Uncleared Adult in question does come to the home on the weekends which are Non Childcare hours. Therefore, this allegation has been determined unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
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 2
Control Number 30-CC-20230210160618
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: MACK FAMILY CHILD CARE
FACILITY NUMBER: 197492937
VISIT DATE: 03/23/2023
NARRATIVE
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A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of this report, notice of site visit and appeal rights were provided to licensee.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2