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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376617543
Report Date: 09/12/2024
Date Signed: 09/12/2024 03:43:39 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/27/2024 and conducted by Evaluator Adrian Castellon
COMPLAINT CONTROL NUMBER: 20-CC-20240627120501
FACILITY NAME:RENTERIA, ELIZABETH FAMILY CHILD CAREFACILITY NUMBER:
376617543
ADMINISTRATOR:ELIZABETH RENTERIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 402-2094
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:14CENSUS: 10DATE:
09/12/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Elizabeth Renteria TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Provider is not following admission procedures and parental rights of minor in care.
INVESTIGATION FINDINGS:
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On 9/12/24, at 10:30 AM, Licensing Program Analyst (LPA) Adrian Castellon conducted an inspection to conclude the complaint investigation regarding the above allegation. LPA advised licensee Elizabeth Renteria of the purpose of the inspection and was granted facility entry. It was alleged that the Provider is not following admission procedures and parental rights of minor in care. During the course of the investigation, two unannounced inspections were conducted. Interviews were conducted with reporting party, staff and daycare parents. Based on the records review and licensee's admission, provider is not following admission procedures and parental rights of minor in care. Parents Rights Notification (LIC995A), Caregiver Background Check Process Process, LIC 995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05) were not provided to child's parent. As such, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Violations of the California Code of Regulations, Tittle 22, are being cited on the attached LIC9099D. One Type B citation issued. An exit interview was conducted with licensee and a copy of this report, Appeal Rights and Notice of Site Visit were provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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 20-CC-20240627120501
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RENTERIA, ELIZABETH FAMILY CHILD CARE
FACILITY NUMBER: 376617543
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2024
Section Cited
CCR
102419(d)
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102419 Admission Procedures and Parental and Authorized Representative's Rights (d): At the time of acceptance "... the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parents' Rights LIC995A (8/06)"... LIC 995E and the
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Licensee will provide all required paperwork to each child's representative upon admittance to the facility and will obtain court issued documents regarding custody if not providing required documents. Licensee will submit a declaration of intent to do so and submit to the licensing office by POC date.
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Family Child Care Consumer Awareness Information, LIC 9212 (10/05)." This requirement was not met as evidenced by licensee not providing parent of child in care the three forms listed in the regulation. This could pose a threat to the health and safety of 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: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 20-CC-20240627120501
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: RENTERIA, ELIZABETH FAMILY CHILD CARE
FACILITY NUMBER: 376617543
VISIT DATE: 09/12/2024
NARRATIVE
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 Notice of Site Visit is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3