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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198400116
Report Date: 06/15/2021
Date Signed: 08/10/2021 04:53:30 PM

Unsubstantiated


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
05/06/2021 and conducted by Evaluator Dayna Chambers
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20210506083952
FACILITY NAME:LONGWOOD FAMILY CHILD CAREFACILITY NUMBER:
198400116
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
06/15/2021
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elexis Longwood, LicenseeTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Capacity- Facility is operating over capacity
Ratio-Facility is operating out of ratio
Personal Rights-Staff did not meet the needs of chlidren in care
Personal Rights-Staff did not intervene in appropriate interactions between children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Amended LIC 9099 report on 08/10/2021- allegation findings amended
On June 15, 2021 at 1:30pm, due to COVID 19 SOE, LPA was unable to visit home in person. LPA Chambers conducted an unannounced inspection at 1:35pm on 06/15/2021 to deliver findings for the above allegations via Facetime. LPA met with Elexis Longwood, Licensee who assisted with the inspection. There were 4 children in care. A copy of this 9099 report will be emailed to Elexis Longwood, Licensee at: sweptawayy2012@gmail.com and a return email reply will serve as an acknowledgement of receipt of the report.

During this investigation, LPA interviewed parents, staff, and licensee, observed/verified information on Guardian, and other documents.
Based on interviews conducted, documents received, Guardian, FAS, and file review, there were no witnesses or disclosures regarding the above allegations, these allegations above are Unsubstantiated.
Exit interview was conducted with Elexis Longwood, Licensee. Notice of Site visit to be posted for 30 days in home.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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