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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364842493
Report Date: 05/18/2022
Date Signed: 05/18/2022 05:17:00 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, 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
05/11/2022 and conducted by Evaluator Justin Giese
COMPLAINT CONTROL NUMBER: 09-CC-20220511152909
FACILITY NAME:FOSTER FAMILY CHILD CAREFACILITY NUMBER:
364842493
ADMINISTRATOR:FOSTER, LOLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 616-2431
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:14CENSUS: 5DATE:
05/18/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Lola FosterTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Uncleared adults living in the home
Daycare children are exposed to harmful substances
Licensee does not meet posting requirements
Facility has pest infestation
Facility is unclean
INVESTIGATION FINDINGS:
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On 05/18/2022 at time listed above, Licensing Program Analyst (LPA) Justin Giese conducted an unannounced visit to the facility for the purpose of initiating a complaint investigation, relating to the above allegations. LPA met with Licensee, Lola Foster. LPA discussed purpose of visit, took census and conducted interviews with the Licensee.

The following was Alleged: Uncleared adults living in the home.

At 1030:am LPA entered the facility and discussed the above allegation with the Licensee. Licensee stated they had an adult that lived in the daycare. At 10:32am Licensee contacted said individual on the telephone. LPA was able to speak to said individual and record verbal confirmation that they live in the home and assist with daycare children. LPA reviewed the Licensee's application for family child care home and did not observe said individual listed as a resident.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
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-20220511152909
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: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 364842493
VISIT DATE: 05/18/2022
NARRATIVE
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Additionally, at 10:45am LPA was provided with said individuals personal information, LPA reviewed facility criminal record clearances on the Guardian website and noted that said individual had a prior fingerprint clearance and association to a different family child care home but did not have proper criminal records transfer or association before residing or initial presence in this facility.

The following was alleged: Daycare children are exposed to harmful substances. It was reported the children are exposed to smoking, the facility smells of smoke and children are exposed to harmful substances in the home.

Licensee stated no individuals smoke in the facility. LPA was unable to smell smoke or observe smoking paraphernalia while touring the facility. Between 10:30am and 11:30am LPA toured all areas of the facility. Between this time frame, LPA observed multiple accessible harmful substances accessible to children in care. LPA observed an unsecured off limits laundry room which had direct access to laundry detergents and cleaning compounds. LPA observed personal hygiene products in all facility restrooms. Additionally, LPA observed lighter fluid, propane tanks, barbecue grills and debris in the facility's on limits backyard.

The following was alleged: Licensee does not meet posting requirements. It was reported the Licensee did not have their Facility License or Community Care Licensing required documents posted.

at 10:30am entered and began touring the Facility. LPA did not observe the required Licensing postings, near the facility entrance or other prominent locations in the day care areas. Licensee stated the facility was recently painted and the required postings were taken down but never put back in place. At 10:50am Licensee located their Facility License and Parents Rights postings in a desk drawer and presented them to LPA.

The following was alleged: Facility has pest infestation.

Licensee acknowledges the facility has a pest infestation and stated an exterminator came to assess the situation some time ago. Licensee was unable to corroborate the date or time the exterminator made contact with the facility or produce documentation or receipt for services provided. At 11:00am LPA observed active and live cockroaches in one of the Facility's restrooms.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 09-CC-20220511152909
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: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 364842493
VISIT DATE: 05/18/2022
NARRATIVE
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The following was alleged: Facility is unclean.

Licensee stated they are aware their Facility has fallen into disrepair and acknowledges it needs a deep cleaning. While touring the facility LPA observed sticky floors, smudges on walls, stains from spilled liquids, dirty diapers, broken furniture, and ruminants of food throughout the facility.

Based on LPAs interviews and direct observations, the preponderance of evidence standard has been met, therefore the above allegations: Uncleared adults living in the home, Daycare children are exposed to harmful substances, Licensee does not meet posting requirements, Facility has pest infestation and Facility is unclean are found to be SUBSTANTIATED.

Please see attached LIC9099D for Type A and Type B Deficiencies Cited

A Civil Penalty of $500 will be assessed during this investigation for Criminal Record Clearance. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”.

LPA issued a Notice of Site Visit and verified it was posted in a prominent location at the facility. Licensees understands that the Notice of Site Visit must remain posted for the next 30 days along with a copy of all Type A deficiencies cited during this inspection. A copy of all Type A deficiencies cited during this inspection must also be immediately (within 24 hours of child’s next day in care) given to the parents of all children enrolled in the child care facility and any children enrolled into the child care facility over the next 12 months (at the time of enrollment). Licensees are required to have all parents sign and date the Acknowledgement of Receipt of Licensing Reports (LIC9224) and maintain a copy in each child’s file. A copy of this report, LIC9224 and Appeal Rights (LIC9058) were provided during this inspection.

An exit interview was conducted, and LPA provided Licensee, Lola Foster with a copy of this report on 05/18/2022.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 09-CC-20220511152909
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: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 364842493
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/19/2022
Section Cited
HSC
1596.8555
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Posting of License : A licensed child day care facility shall post its license in a prominent, publicly accessible location in the facility. A family day care home shall comply... during the hours when clients are present.
This was not met as evidenced by:
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Licensee undersdtands the inportance of this requirement and stated the required postings were taken down when the facility was re-painted. Licensee was able to locate their Facility LIcense and Parent's Rights documents at time of visit.
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Based on LPA's observations and statements made, the Licensee failed to adhere to the required posting requirements of the Facility's Licesnse and other required documents. This poses a potential health, safety, or personal rights risks to children in care.
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Licensee will adhere to their posting requirements and will post all required documents in a prominent location. Licensee will correct this citation on or before the plan of correction date. LPA will return at a later date to verify this have been met.
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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: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 09-CC-20220511152909
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: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 364842493
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/18/2022
Section Cited
CCR
102370(c)(2)
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Criminal Record Clearance
(2) The licensee shall submit these fingerprints... prior to the individual's employment, residence, or initial presence in the child care home.

This was not met as evidenced by:
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Licesnsee understands the importance of this regulation and stated adult resident has clearance from previous employment in a family childcare home. Licensee was unaware of process necessary to make the transfer.
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Based on LPA's observation interview and records reviewed, Licensee failed to transfer adult resident's fingerprint clearance and association to the facility prior to them residing in the home. This poses an immediate health and safety risk to children in care.
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Licensee will immedietly take the appropriate steps necessary to transfer criminal records clearance for adult resident. Licensee understand this individual cannot be present in facility until necessary transfer is completed.
A Civil Penalty of $500 will be assessed.
Type A
05/19/2022
Section Cited
CCR
102417(g)(4)
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Operation of a Family Child Care Home: (g)(4) Poisons, detergents, cleaning compounds... and other items which could pose a danger... to children shall be stored where they are inaccessible to children.

This was not met as evidenced by:
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Licensee acknowledges the facility has harmful substances accessible to children and understands poisons and toxins are required to be key locked. immediate and potential health and safety concerns need to be constantly assessed while children are in care.
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Based on LPA's direct observations from 10:30-11:30am, LPA observed cleaning compounds, personal hygiene products, lighter fluid, propane tanks, barbecue grills and debris accessible to children in care. This is an immediate health and safety risk to children in care.
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Licensee will immedietly remove harmfull substances and properly secure them in a key locked location. Licensee will properly secure laudry room and address safety hazards noted in backyard on or before the stated proof of correctios date. LPA will return to inspect corrections at a later date.
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: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 09-CC-20220511152909
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: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 364842493
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/19/2022
Section Cited
CCR
102423(a)(2)
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Personal Rights (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee. (2) To receive safe, healthful, and comfortable accommodations...
This was not met as evidenced by:
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Licensee understands the importance of this regulation and stated they have been in contact with an exterminator for this issue in the past.
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Based on LPA's observations and interviews, Licensee acknowledges faciliy has a pest infectation. At 11:00am LPA observed live and active cockroaches in the facility bathroom. This is an immediate health and safety risk to children in care.
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Licensee will immediately address this pest infestation and contact an exterminator for services to be rendered. Licensee will submit proof of conact or services rendered to LPA on or before proof of correction date.
Type A
05/19/2022
Section Cited
CCR
102417(b)
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Operation of a Family Child Care Home (b) The home shall be kept clean and orderly...




This was not met as evidenced by:
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Licensee acknowledges the facility has fallen into disrepair and understands the facility needs to be clean and orderly at all times.
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Based on LPA's observation and interviews, LPA observed sticky floors, dirty walls, spilled liquids, dirty diapers, broken furniture, and remnants of food throughout the facility. This is an immediate health and safety risk to children in care.
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Licensee will immediately deep clean the facility and remove or repair all broken furniture on or before the stated plan of correction date listed. LPA will return to the facility at a later date to physically inspect its condition.
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: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 6