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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198013548
Report Date: 08/31/2023
Date Signed: 08/31/2023 06:46:36 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/25/2023 and conducted by Evaluator Alicia Mooberry
COMPLAINT CONTROL NUMBER: 54-CC-20230525145012
FACILITY NAME:ADAMS & MCCRAW FAMILY CHILD CAREFACILITY NUMBER:
198013548
ADMINISTRATOR:ADAMS, RAYJENNIA&MCCRAW, MFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 564-0901
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:14CENSUS: DATE:
08/31/2023
UNANNOUNCEDTIME BEGAN:
04:45 PM
MET WITH:RayJennia AdamsTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Children in care engaged in physical altercations with each other due to lack of supervision.
INVESTIGATION FINDINGS:
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On 8/31/32 at 3:00 p.m., Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced complaint inspection to conclude the investigation for the above allegation(s). LPA met with Shiree Adams, Assistant, who was alone with 1 child and informed of the purpose of the visit. During the visit 6 more children arrived. Rejianna Adams, Licensee arrived at 3:30pm.

During the course of this investigation, LPA conducted interviews with Facility Staff, children and witnesses and obtained pertinent documentation including photos of Child #1 with a red and swollen lip. Licensee confirmed that Child #1 reported to Licensee that they were kicked on the mouth during after hour care. Licensee confirmed that there was no digital video and audio monitoring device in the bedroom when children sleep after hours at the time of the incident. Licensee confirmed that they did not report the incident to the parent of child #1 because there was no bleeding or swelling. Additonal Interviews reported witnessing children fighting one another and child punch another in the stomach during care when adults were in another room. ------Page1 Report Continued 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
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 5
Control Number 54-CC-20230525145012
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ADAMS & MCCRAW FAMILY CHILD CARE
FACILITY NUMBER: 198013548
VISIT DATE: 08/31/2023
NARRATIVE
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Based on LPA interviews conducted, and documents reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, 102417 and 102416.2. One (1) A deficiency for Lack of Supervision and One (1) B deficiency for Reporting Requirements are being cited on the attached LIC. 9099D.

LPA discussed with licensees Adams and McCraw the requirement to ensure that children in care are supervised at all times to ensure their safety.

LPA discussed with licensee the right of individuals to make reports and complaints without discrimination or retaliation.

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 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form LIC9224 during this visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee RayJennia Adams. A copy of this report and appeal rights were discussed.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 54-CC-20230525145012
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ADAMS & MCCRAW FAMILY CHILD CARE
FACILITY NUMBER: 198013548
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/31/2023
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home: (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times.

Thiis requirement is not met as evidenced by:
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The licensee has purchased a video and aido monitor and placed in the bedroom where daycare children sleep after hours. Per licensee, they will provide a plan of supervision to ensure children are safe.
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Based on interview and review of documents. The licensee failed to ensure that children in care are adequately supervised resulting in children injured. This poses an immediate threat to the health and safety of children in 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: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 54-CC-20230525145012
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ADAMS & MCCRAW FAMILY CHILD CARE
FACILITY NUMBER: 198013548
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2023
Section Cited
CCR
102416.2(f)(1)
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Any injury suffered by a child in care shall be reported to that child's parent or authorized representative regardless of treatment by a medical professional.

This requirement was not met as evidenced by
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Per licensee, they will ensure to report any child injury to the parents/authorized representaive regarless if the child needs medical attention. A written stamenent was provided.
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Per licensee interview, Child #1 reported to licensee that they were injured and licensee did not report to the parent.
This poses a potential risk to the health and safety of children in 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: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5