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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334843071
Report Date: 11/03/2022
Date Signed: 11/03/2022 10:06:57 AM

Unsubstantiated


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 STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/03/2022 and conducted by Evaluator Nasha King
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20221003170152
FACILITY NAME:KING FAMILY CHILD CAREFACILITY NUMBER:
334843071
ADMINISTRATOR:WENDY KINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 567-8839
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:14CENSUS: 10DATE:
11/03/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Wendy KingTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Personal Rights - Day-care child sustained an injury while in care.
INVESTIGATION FINDINGS:
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On the above date and time listed, Licensing Program Analyst (LPA) Nasha King arrived at the facility for the purpose of delivering the complaint findings into the above-referenced allegation. LPA met with the Licensee, Wendy King. LPA toured the facility, conducted census, and discussed with Mrs. King the conclusion of the complaint investigation.

On October 3, 2022, Community Care Licensing (CCL) received a complaint, alleging that day-care child sustained an injury while in care. An initial 10-day visit was conducted on October 10, 2022, by LPA King. During this visit, LPA spoke with the Licensee regarding the alleged incident, reviewed and obtained copies of facility records, and the investigation was extended at that time.

In regards to the allegation day-care child sustained an injury while in care, it was alleged that child #1 (C1)

See LIC 9099C for a continuation of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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 2
Control Number 10-CC-20221003170152
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KING FAMILY CHILD CARE
FACILITY NUMBER: 334843071
VISIT DATE: 11/03/2022
NARRATIVE
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was injured on a scooter, resulting in C1 sustaining a split chin and a bump on their forehead. Per confidential interviews conducted and information gathered, the investigation revealed that the injury occurred while in the care of the Licensee. However, the Licensee observed the fall, assessed the injury, and then took appropriate action. Although the injury occurred, there is no evidence to prove or disprove that the injury occurred due to a lack of supervision.

Based on the information obtained during this investigation, it has been determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted, and this report was reviewed with the Licensee, Wendy King, and a copy was provided.

Appeal rights were discussed and provided during the exit interview.

A Notice of Site visit was given, and the Licensee understands that it must remain posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2