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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 367700382
Report Date: 10/29/2024
Date Signed: 10/29/2024 01:03:13 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/04/2024 and conducted by Evaluator Sherell Braddock
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240904161532
FACILITY NAME:HARRIS FAMILY CHILD CAREFACILITY NUMBER:
367700382
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
10/29/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brittany Harris - Licensee TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Allegation- Out of ratio
INVESTIGATION FINDINGS:
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On Tuesday, October 29, 2024, Licensing Program Analyst (LPA) Sherell Braddock conducted an unannounced visit at the facility to deliver complaint investigation findings. Upon arrival, LPA was met by Licensee Brittany Harris who guided LPA on a tour of the facility. LPA observed 3 children in care with 1 staff providing care and supervision.

The investigation consisted of interviews with staff, children's parents, review of facility roster and other pertaining documents related to the complaint investigation. Documentation reviewed and confidential interviews conducted disclosed that between June 2024 and September 2024 the licensee was out of ratio.

The facility was out of ratio during the periods when both child care provider was providing care at the same facility.



Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
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 3
Control Number 12-CC-20240904161532
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HARRIS FAMILY CHILD CARE
FACILITY NUMBER: 367700382
VISIT DATE: 10/29/2024
NARRATIVE
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Based on information obtained, observations, interviews conducted, and relevant information received, this allegation is deemed SUBSTANTIATED. The facility was cited one Type A Citation in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes. (See LIC 9099-D for cited deficiency). A substantiated finding means that the allegation is valid because the preponderance of the evidence standard has been met.

This inspection was conducted in person. LPA read the report with Licensee, Brittany Harris and provided a copy of the report, Appeal Rights, and a Notice of Site Visit was given and must be posted for 30 days. Exit interview conducted.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20240904161532
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: HARRIS FAMILY CHILD CARE
FACILITY NUMBER: 367700382
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/30/2024
Section Cited
CCR
102416.5(c)
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102416.5 Staffing Ratio and Capacity

The total licensed capacity for a Small Family Child Care Home shall not exceed eight children.
This requirement is not met as evidenced by:
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Licensee provided documentation of a change of address for the other provider.
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Based on Docmuentation review, between June 2024 and September 2024 The facility was out of ratio during the periods when both child care providers was providing care at the same facility.
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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: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3