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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334818193
Report Date: 11/15/2022
Date Signed: 11/15/2022 11:36:47 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/17/2022 and conducted by Evaluator Aman Sharma
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220817151813
FACILITY NAME:OCAMPO FAMILY CHILD CAREFACILITY NUMBER:
334818193
ADMINISTRATOR:RICHARD OCAMPOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 755-7036
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY:14CENSUS: 9DATE:
11/15/2022
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Richard OcampoTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Personal Rights: Day care children sustained injuries while in care.
Reporting Requirements: Licensee did not notify day care child’s parents of incidents.
INVESTIGATION FINDINGS:
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On the date and time listed above, Licensing Program Analysts (LPA’s) Aman Sharma and Giselle Carbullido arrived at the facility to conclude an investigation regarding the above complaint allegations received on 08/17/2022. Previous inspections were conducted on 08/24/2022 and 09/21/2022. LPAs were given access to the facility by the licensee, Richard Ocampo. LPAs informed licensee of the purpose of today’s inspection and toured the facility. Also present during today’s inspection were two staff and there were 9 children in care. LPA’s met with the licensee to further discuss the complaint allegations and deliver findings.
During the investigation, LPA gathered information and interviewed pertinent parties related to the complaint allegations. It was alleged that day care child(ren) sustained injuries while in care and Licensee did not notify day care child(ren) parents of the incidents.

The following information was collected during the investigation:
SEE 9099C........
Substantiated
Estimated Days of Completion: 30-90
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
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 6
Control Number 09-CC-20220817151813
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: OCAMPO FAMILY CHILD CARE
FACILITY NUMBER: 334818193
VISIT DATE: 11/15/2022
NARRATIVE
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Based on interviews with pertinent parties including the licensee, it was disclosed that a child sustained multiple injuries, with the latest injury including redness on the cheek while in care at the facility. Licensee stated that on or about August of 2021, there was an incident at the facility where a child suffered an injury that resulted in a laceration and/or a bump on the back of their head. It was also reported, the child has been injured multiple times while in care at the facility. Licensee admitted that on or about 08/17/2022, there was another incident involving the subject child being scratched near their eye by another child, while in care.

It was also alleged that Licensee did not notify day care child’s parents of these incidents. By licensee’s own admission, these injuries occurred while under care and supervision of facility staff. Licensee confirmed these incidents occurred, but had no evidence that parents were notified. According to Licensees, the facility’s policy is to inform parents either verbally or in writing of injuries that occur, while children are in their care. Licensee admitted that on or about 08/17/2022, she did not report an injury that took place in her facility. The parents learned about the injury (scratch on eye and redness on face) once they reached their residence and had to ask licensee about the incident themselves.
According to the licensee, the information was not reported to the parent, due to the parent leaving before they had a chance to tell them. Licensee stated, the parents were engaged in a conversation with another parent and they walked away with their children before licensee could speak with them. Licensee did not place a phone call or text message after the parent left to inform them of what occurred regarding the injury involving their child.

Licensee stated that she writes incident reports and uses text messages or phone calls to inform parents of injuries, but was unable to provide or produce any documentation regarding reporting these incidents.

Based on LPAs interviews, including licensee’s own admission, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12) are being cited on the attached LIC9099D.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 09-CC-20220817151813
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: OCAMPO FAMILY CHILD CARE
FACILITY NUMBER: 334818193
VISIT DATE: 11/15/2022
NARRATIVE
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An exit interview was conducted with the Licensee, Richard Ocampo. Appeal Rights were discussed and issued, a copy of this report was provided, and a Notice of Site visit was issued. 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).

A copy of this report must be made available upon request for the next three years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 09-CC-20220817151813
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: OCAMPO FAMILY CHILD CARE
FACILITY NUMBER: 334818193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/16/2022
Section Cited
CCR
102423(a)(2)
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Personal Rights: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement was not met as evidenced by:
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Licensee agrees to submit letter of understanding of Regulation: 102423(a)(2); including an outline of reporting injuries to the department and notifiation of parents. This is due to licensing no later than POC due date.
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Based on interviews conducted and licensees own admission, it was disclosed a child sustained multiple injuries (laceration/cut on back of head, scratch near their eye and redness on cheek) while at the facility. This poses an immediate health and safety risk to children in care.
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Type A
11/16/2022
Section Cited
CCR
102416.2(f)(1)
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Reporting Requirements: 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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Licensee will submit a step by step written plan of action outlining notitfication to parents for child accidents and inuries by POC due date.
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Licensee confirmed these incidents occurred, but had no evidence that parents were notified.
This poses an immediate health and safety risk to 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: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/17/2022 and conducted by Evaluator Aman Sharma
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220817151813

FACILITY NAME:OCAMPO FAMILY CHILD CAREFACILITY NUMBER:
334818193
ADMINISTRATOR:RICHARD OCAMPOFACILITY TYPE:
810
ADDRESS:1554 POLARIS LANETELEPHONE:
(951) 755-7036
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY:14CENSUS: 9DATE:
11/15/2022
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Richard OcampoTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights : licensee hits day care children.
INVESTIGATION FINDINGS:
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On the date and time listed above, Licensing Program Analysts (LPAs) Aman Sharma and Giselle Carbullido arrived at the facility to conclude an investigation regarding the above complaint allegation received on 08/17/2022, previous inspections were conducted on 08/24/2022 and 09/21/2022. LPAs were given access to the facility by the licensee, Richard Ocampo. LPAs informed licensee of the purpose of today’s inspection and toured the facility. Also present during today’s inspection were two staff and there were 9 children in care. LPAs met with the licensee to further discuss the complaint allegation and deliver findings.
During the investigation, LPA gathered information and interviewed pertinent parties related to the allegation. It was reported that licensee hit a day care child.

The following information was collected during the investigation:

SEE 9099C.........
Unsubstantiated
Estimated Days of Completion: 30-90
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 09-CC-20220817151813
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: OCAMPO FAMILY CHILD CARE
FACILITY NUMBER: 334818193
VISIT DATE: 11/15/2022
NARRATIVE
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It was alleged that on or about 08/17/2022, licensee hit a day care child in the face on the left cheek. Licensee denies the allegation and it was disclosed that the child ran into the licensee’s leg and the child referred to that incident as a “hit”. LPA was unable to corroborate the allegation and attempts to interview the subject child were unsuccessful. There were no other witnesses to the alleged incident. LPA was not able to corroborate, nor negate the allegation that licensee hit a day care child in the face on the left cheek, therefore the allegation is UNSUBSTANTATED.

Based on information obtained during this investigation through interviews conducted and the review of pertinent documentation, the allegation listed above has been determined to be UNSUBSTANTIATED. A finding that the allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred.

An exit interview was conducted with the Licensee, Richard Ocampo. Appeal Rights were discussed and issued, a copy of this report was provided, and a Notice of Site visit was issued. Failure to maintain posting as required, will result in an immediate $100 civil penalty.



A copy of this report must be made available upon request for the next three years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 6