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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376618348
Report Date: 01/31/2023
Date Signed: 02/16/2023 02:06:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 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
11/29/2022 and conducted by Evaluator Michelle Hood
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20221129105705
FACILITY NAME:WILLIAMS, LACY FAMILY CHILD CAREFACILITY NUMBER:
376618348
ADMINISTRATOR:LACY WILLIAMSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 269-8331
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:14CENSUS: 5DATE:
01/31/2023
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Lacy Williams, LicenseeTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Licensee does not properly wash the daycare child's drinking cup.
Daycare children are not afforded appropriate napping accommodations.
INVESTIGATION FINDINGS:
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This is an amended version of an original report created on 01/31/2023. On 01/31/2023 at 12:50 pm, Licensing Program Analyst (LPA) Michelle Hood, made an unannounced complaint inspection to deliver the findings for the above-listed allegations. Upon arrival, LPA met with licensee Lacy Williams and toured the facility. There was a total of five napping daycare children at the time of inspection. LPA conducted interviews with the licensee, reporting party, witness and daycare parents. During an interview, licensee Williams admitted she was not removing the plastic mouthpiece from the sippy cup until a parent brought it to her attention. The licensee stated she has stopped using the plastic mouthpiece sippy cups for children in care. The licensee admitted she has allowed a child to continue napping on the living couch, instead of placing the child on a piece of napping equipment. The LPA observed a child asleep whiile in a high chair. The licensee was provided a Safe Sleep handout which includes napping equipment information.
The preponderance of evidence standard has been met, therefore the allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 3, are being cited on the attached LIC 9099D. An exit interview was conducted and the report was reviewed with the licensee (include name). The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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 4
Control Number 20-CC-20221129105705
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: WILLIAMS, LACY FAMILY CHILD CARE
FACILITY NUMBER: 376618348
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/01/2023
Section Cited
CCR
102423(a)(2)
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102423(a)(2) – Personal Rights. Each child receiving services from a family child care home shall have certain rights that shall not be waived…These rights include…the following: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by:
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The licensee wrote a declaration regarding no longer uses sippy cups and not allowing children to use the appropriate napping equipement.
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Based on the licensee’s admittance the licensee failed to ensure the children’s personal rights by not ensuring children’s sippy cups were clean and by not using appropriate napping equipment for sleeping children. This poses a potential Health, Safety, or Personal Rights risk to persons in care.



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Type B
CCR
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Removed
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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: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 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
11/29/2022 and conducted by Evaluator Michelle Hood
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20221129105705

FACILITY NAME:WILLIAMS, LACY FAMILY CHILD CAREFACILITY NUMBER:
376618348
ADMINISTRATOR:LACY WILLIAMSFACILITY TYPE:
810
ADDRESS:123 HENSON STREETTELEPHONE:
(619) 269-8331
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:14CENSUS: 5DATE:
01/31/2023
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Lacy Williams, LicenseeTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Adult in the home uses inappropriate language in the presence of daycare children.
Licensee uses inappropriate forms of discipline.
The licensee handles daycare children in a rough manner
INVESTIGATION FINDINGS:
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On 01/31/2023 at 12:50 pm, Licensing Program Analyst (LPA) Michelle Hood, made an unannounced complaint inspection to deliver the findings for the above-listed allegations. Upon arrival, LPA met with licensee Lacy Williams and toured the facility. There was a total of five napping daycare children present at the facility at the time of inspection.

During the investigation, interviews were conducted with daycare children, daycare parents, reporting party, witness and licensee. The daycare parents stated there’s been no issues or concerns regarding inappropriate language, forms of discipline, or the licensee handling the children roughly. The licensee denies the allegations.

Due to conflicting statements obtained during the investigation, the above allegations are found to be UNSUBSTANTIATED meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.








Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 20-CC-20221129105705
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: WILLIAMS, LACY FAMILY CHILD CARE
FACILITY NUMBER: 376618348
VISIT DATE: 01/31/2023
NARRATIVE
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The licensee was provided appeal rights (LIC9058 01/16) and their signature on this form acknowledges receipt of these rights. Notice of site visit was provided to the director and must remain posted for 30 days. An exit interview was conducted, and the report was reviewed with the licensee Lacy Williams.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4