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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197493875
Report Date: 10/07/2021
Date Signed: 10/08/2021 09:57:47 AM

Substantiated


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
08/11/2021 and conducted by Evaluator Judy Laureano
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210811144748
FACILITY NAME:FULLER FAMILY CHILD CAREFACILITY NUMBER:
197493875
ADMINISTRATOR:FULLER, MARLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 505-9749
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:14CENSUS: 13DATE:
10/07/2021
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Marlo FullerTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Personal Rights: Staff member yelled at day care child.
INVESTIGATION FINDINGS:
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On 10/7/2021, Licensing Program Analysts (LPAs) Lillian Casillas and Judy Laureano conducted an unannounced complaint visit for the purpose of concluding the investigation regarding the allegations above. LPA met with Assistant, Adlean Fuller. Licensee, Marlo Fuller, arrived at approximately 1:00 p.m. LPA observed 13 children with 2 staff.

On 8/18/2021, LPAs Lillian Casillas and Judy Laureano conducted an unannounced 10-day complaint investigation. LPAs toured the facility with Licensee and obtained copies of the following documents: children’s roster (LIC9040), sign-in/sign-out sheets for 8/5-8/6/2021 and 8/18/2021, and staff schedule. LPAs interviewed Licensee and Child 1.

[CONTINUE ON PAGE 2]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
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 30-CC-20210811144748
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: FULLER FAMILY CHILD CARE
FACILITY NUMBER: 197493875
VISIT DATE: 10/07/2021
NARRATIVE
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PAGE 2

On 9/10/2021, LPA Casillas conducted an unannounced follow up complaint investigation. LPA met with Assistant, Chanta Rankin, and Assistant, Adlean Fuller. LPA interviewed both assistants and 7 children in care. LPA also obtained the following documents: sign in/out sheet for 9/10/2021 and the Daily Situation/Shift Report for 9/9/2021.

Based on the investigation, which included interviews with relevant parties, and information received throughout the investigation the allegation of Personal Rights staff yell at day care children the preponderance of evidence has been met. Therefore, the above allegation is found to be SUBSTANTIATED. A Type A deficiency was cited during today's inspection (see LIC 9099-D for details).

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224).

An exit interview was conducted and a copy of this report along with the Notice of Site Visit and Appeal Rights were provided to Licensee.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20210811144748
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: FULLER FAMILY CHILD CARE
FACILITY NUMBER: 197493875
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/07/2021
Section Cited
CCR
102423
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102423 Personal Rights
(a) Each child..shall have certain rights...(1) To be treated with dignity in his/her personal relationship with staff and other persons. This requirement was not met as evidenced by:
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Licensee agrees to read Tittle 22 or PR & Care & Sup. & the CCL videos along with her 2 assistants on personal rightshttps://ccld.childcarevideos.org/family-child-care-providers/childrens-personal-rights-in-child-care/ & Supervising Children in Family Child Care https://ccld.childcarevideos.org/family-child-care-providers/supervising-children-in-family-child-care/
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Based on information revealed the children’s personal rights were violated while in care. Children were not treated with dignity and respect. which poses an immediate Health, Safety or Personal Rights risk to children in care.
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Licensee agrees to submit a LIC855 for herself & 2 staff confirming review and discussion of the video & read on Tittle 22. Additional fee based training discussed & info. given to licensee. LIC 855 will be emailed to LPA by 11/05/2021.
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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: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3