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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494925
Report Date: 09/17/2024
Date Signed: 09/17/2024 01:24:53 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
09/06/2024 and conducted by Evaluator Tatiana Bickham
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20240906123804
FACILITY NAME:DAN FAMILY CHILD CAREFACILITY NUMBER:
197494925
ADMINISTRATOR:MICHAL DANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 210-9352
CITY:LOS ANGELESSTATE: CAZIP CODE:
90048
CAPACITY:14CENSUS: 11DATE:
09/17/2024
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Michal DanTIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Facility staff took inappropriate photos of child.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced complaint inspection on 09/17/2024 at 11:05 AM. LPA met with Licensee, Michal Dan to discuss the above allegation. At the time of arrival LPA observed 11 children (two of whom were infants) with 1 additional staff.

During today's visit, LPA toured the day care home, obtained a copy of the children's roster, reviewed children's files and interviewed the Licensee.

Per Reporting Party, staff took inappropriate photos of child.

During the interview with the Licensee, the Licensee stated while taking a picture of two children to send to a parent, she did not realize there was another child in the photo that was being changed.
Page 1.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
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 8
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
09/06/2024 and conducted by Evaluator Tatiana Bickham
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20240906123804

FACILITY NAME:DAN FAMILY CHILD CAREFACILITY NUMBER:
197494925
ADMINISTRATOR:MICHAL DANFACILITY TYPE:
810
ADDRESS:6104 WARNER DRIVETELEPHONE:
(310) 210-9352
CITY:LOS ANGELESSTATE: CAZIP CODE:
90048
CAPACITY:14CENSUS: 11DATE:
09/17/2024
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Michal DanTIME COMPLETED:
01:40 PM
ALLEGATION(S):
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9
Licensee did not provide a copy of the Family Child Care Home Notification of Parents’ Rights to parent upon admission.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced complaint inspection on 09/17/2024 at 11:05 AM. LPA met with Licensee, Michal Dan to discuss the above allegation. At the time of arrival LPA observed 11 children (two of whom were infants) with 1 additional staff.

During today's visit, LPA toured the day care home, obtained a copy of the children's roster, reviewed children's files and interviewed the Licensee.

Per Reporting Party, Licensee did not provide a copy of Notification of Parents Rights to parent upon admission.

During interview with the Licensee, the Licensee stated she was not aware the parents had to get a copy of the form. Per Licensee, she only thought a signature was required, and the top portion of the form was
Page 1.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 58-CC-20240906123804
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: DAN FAMILY CHILD CARE
FACILITY NUMBER: 197494925
VISIT DATE: 09/17/2024
NARRATIVE
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optional.

Based on the LPA observations, and interview concluded with Licensee the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22 (code) is being cited on the attached LIC 9099D

Exit interview was conducted with Licensee, Michal Dan. Appeals Rights and the Notice of Site visit were provided.

The Notice of Site Visit must remain posted for 30 days during the hours of operation. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 58-CC-20240906123804
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: DAN FAMILY CHILD CARE
FACILITY NUMBER: 197494925
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
CCR
102419(d)
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102419- Admission Procedures and Parental and Authorized Representative's Rights..(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parents’ Rights.
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LPA informed Licensee Family Child Care Home Notification of Parents' Rights must be given to each parent at the time of enrollment. Licensee is to ensure that all parents get the top of the form for Parents' Rights. LPA reviewed Children's form packet with Licensee.
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This requirement was not met as evidenced by:
LPA observation of records review and interview, Licensee did not ensure parents received a copy of Family Child Care Home Notification of Parents' Rights.
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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: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 8
Control Number 58-CC-20240906123804
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: DAN FAMILY CHILD CARE
FACILITY NUMBER: 197494925
VISIT DATE: 09/17/2024
NARRATIVE
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The child's private area was exposed. Licensee stated when taking photos to send to parents she will be more aware of her surroundings to ensure nothing else is in the photo.

Based on the LPA observations, and interview concluded with Licensee the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22 (code) is being cited on the attached LIC 9099D.

Exit interview was conducted with Licensee, Michal Dan. Appeals Rights and the Notice of Site visit were provided.

The Notice of Site Visit must remain posted for 30 days during the hours of operation. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 58-CC-20240906123804
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: DAN FAMILY CHILD CARE
FACILITY NUMBER: 197494925
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
CCR
10243(a)(1)
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(a) Each child receiving services from a family child care home shall...(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 was informed to provide a written statement that she is aware of the child's personal rights and to review her surroundings before taking and sending pictures of children to parents by 9/20/24.
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Based on LPA observation and interview with the Licensee, the Licensee did not ensure a child's private area was not exposed in a photo.
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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: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 8 of 8