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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 406215020
Report Date: 05/22/2024
Date Signed: 05/22/2024 01:13:40 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/07/2024 and conducted by Evaluator Elvin Baddley
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20240507083723
FACILITY NAME:LEMOINE-BECERRA FAMILY CHILD CAREFACILITY NUMBER:
406215020
ADMINISTRATOR:JAMIE LEMOINE-BECERRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 458-5433
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:14CENSUS: 0DATE:
05/22/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Jamie Lemoine- BecerraTIME COMPLETED:
12:59 PM
ALLEGATION(S):
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1. Licensee is not at the facility the required amount of time
2. Staff are not properly trained on what to do if a child gets injured
INVESTIGATION FINDINGS:
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On 5/22/24, Licensing Program Analysts (LPAs) Elvin Baddley and Joaquin Mendez made an unannounced inspection to the aforementioned Family Child Care Home (FCCH) in order to investigate and deliver the findings with regard to the above allegations. LPAs met with Jamie Lemoine- Becerra, Licensee of the FCCH, and explained the nature of the inspection. LPAs notes no children are on site and the facility's operation ceased on 5/17/24, according to the Licensee.

The investigation included four unannounced inspections as well as record reviews and interviews of the Complainant, Assistants, the Licensee and related individuals. The allegations of the Complaint notes the Licensee is not at the facility the required amount of time and staff are not properly trained on what to do if a child gets injured. Investigation revealed corroborating information with regard to each allegation. Namely, the Licensee is not at the FCCH the required amount of time and staff members did not demonstrate proper training protocols when interviewed by CCLD staff.
(CONT. LIC 9099, Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
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 17-CC-20240507083723
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LEMOINE-BECERRA FAMILY CHILD CARE
FACILITY NUMBER: 406215020
VISIT DATE: 05/22/2024
NARRATIVE
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Based on LPAs observations, record review and interviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, are being cited on the attached LIC 9099D.

Upon receipt of this report, Licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy.

A closing interview was conducted with Licensee and a Plan of Correction was discussed. Licensee was provided and advised of Appeal Rights. Licensee's signature at the bottom of this report acknowledges Licensee received the reports and understand their rights.

The Notice of Site Visit was also provided to the Licensee as required by H&S Code Section 1596.817. The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00 may apply.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20240507083723
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LEMOINE-BECERRA FAMILY CHILD CARE
FACILITY NUMBER: 406215020
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/23/2024
Section Cited
CCR
102417(a)
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The licensee shall be present in the home...Temporary absences shall not exceed 20 percent of the hours that
the facility is providing care per day. This requirement was not met as evidenced by Licensee not being at the FCCH from 4/1/24 to 5/1/24 the required amount of time.
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Licensee to submit an written plan explaining how Licensee will maintain presence at the FCCH 80% per day, and alternative plans should Licensee's absence exceed 20%.Plan of Correction to be provided to CCLD (elvin.baddley @dss.ca.gov) no later than the close of business 5/23/24.
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This poses an immediate health, safety or personal rights risks to persons in care.
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Type A
05/23/2024
Section Cited
CCR
101223(a)(1)
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Personal Rights- The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as
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Licensee to outline a plan how Assistants are trained to address an injury of a child in care. Plan of Correction to be provided to CCLD (elvin.baddley @dss.ca.gov) no later than the close of business 5/23/24.
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evidence of FCCH Assistants not being properly trained on what to do in case of the injury to C1 5/1/24.
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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: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3