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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334846201
Report Date: 05/12/2023
Date Signed: 05/12/2023 04:30:21 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 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
05/10/2023 and conducted by Evaluator Raymond Moorehead
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20230510091911
FACILITY NAME:DAVIS FAMILY CHILD CAREFACILITY NUMBER:
334846201
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 12DATE:
05/12/2023
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Sarah DavisTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Licensee is operating over capacity.
INVESTIGATION FINDINGS:
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On 5/12/2023 at 2:45 PM Licensing Program Analysts (LPAs) Raymond Moorehead Jr. and Patricia Berry conducted a compaint investigatiion. LPAs were granted access into the facility and met with Sarah Davis. LPAs toured the facility and took a census.

Allegation: Licensee is operating over capacity. It was alleged the facility was over capacity. LPAs observed 12 children at the facility, including 4 infants, 6 pre schoolers, and 2 school age children. This facility is a small license, and is pending a large. According to Title 22 regulation 102416 Staffing Ratio and Capacity (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

Exit interview conducted with licensee report, appeal rights, acknowledgment of receipt, and notice of site visit issused.
Notice of site visit must be posted for 30 days.
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
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 2
Control Number 09-CC-20230510091911
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: DAVIS FAMILY CHILD CARE
FACILITY NUMBER: 334846201
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2023
Section Cited
CCR
102416(a)
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Staffing Ratio and Capacity (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

This requirement was not met as evidence by
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Licensee immidiately had 4 children go home.

Licensee stated that she will partake in the videos on the community care licensing website for supervision at www.ccld.ca.gov.
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Based on LPA's observations, there were 12 children, 4 infants,6 preschoolers, and 2 school age children. Licensee is only licensed for a small (8 children).
This is an immidiate risk to the health and safety of the children in care.
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Licesnee stated that she will send an email to CCL stating that she watched the ccld videos by 5/15/2023.
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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: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC9099 (FAS) - (06/04)
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