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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483009279
Report Date: 07/13/2021
Date Signed: 07/13/2021 05:20:06 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/26/2021 and conducted by Evaluator Elpidia Hernandez Torres
COMPLAINT CONTROL NUMBER: 01-CC-20210526090743
FACILITY NAME:WALKER, CHARMENA FCCHFACILITY NUMBER:
483009279
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
07/13/2021
UNANNOUNCEDTIME BEGAN:
04:25 PM
MET WITH:Licensee Charmena Walker TIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Provider left daycare children unattended
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elpidia Hernandez Torres conducted a complaint investigation visit with Licensee Charmena Walker to deliver the finding regarding the above allegation. It was alleged that provider left daycare children unattended, specifically that the Licensee left the children without care and supervision while at the facility.

On 06/04/2021, an initial interview was conducted with licensee who stated she has; a childcare assistant who is always at her house and that on 05/22/21 she wasn’t feeling good, so she stayed upstairs while her assistant stayed downstairs with the children. Licensee could not produce documents to show this assistant/roommate was hired as a facility staff member. Licensee further claimed she never left the house that day. On 06/09/21, an interview with the licensee’s assistant/roommate, corroborated that licensee wasn’t feeling well on 05/22/21 and she stayed in bed that day. This assistant/roommate was unable to confirm what care and supervision was provided to the children throughout the day.

Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
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 01-CC-20210526090743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: WALKER, CHARMENA FCCH
FACILITY NUMBER: 483009279
VISIT DATE: 07/13/2021
NARRATIVE
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On 06/02/21 Interviews were conducted with two children and one adult. Based on interviews, on 05/22/21 Licensee left five to ten minutes after four day-care children were dropped off at approximately 2:30 pm and didn’t return at any time before the children were picked up at approximately 8:00 pm. Interviews further revealed assistant/roommate was in the home, but was not providing care and supervision over the children. When children were picked up, no adult opened the door and neither the Licensee nor roommate were in sight at the time of pick up. The licensee did not contact the parent at any time during the day to pick up the children. The children, ages one, three, ten, and thirteen, were left unattended throughout the day in which the older children attended to the care needs of the younger children by changing their diapers and feeding them food that the parent had provided.

Based on the interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations 102417(a) is being cited on the attached LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. Appeal rights were provided and exit interview conducted.

All licensing reports are public information and must be made available upon request for at least three years. The Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20210526090743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: WALKER, CHARMENA FCCH
FACILITY NUMBER: 483009279
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/14/2021
Section Cited
CCR
102417(a)
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The licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement is not met as evidenced by: . . .
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Licensee stated she is in the process of hiring an assistant, and will complete an employee file. Licensee also started she will create an emergency plan for the asistant to follow should licensee fall ill again. The plan will include scenarios such as: " If I become un repsonsive or ill, to make sure kids are never left unattended", to inform parents licensee is not feeling well and if day care will remain open with assistant as the sole provider for the day.
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. . . Interviews revealed and Licensee confirmed that on 05/22/21 at approximately 2:40pm, the Licensee left four, day care children with her roommate for at least five hours in which children’s care and supervision needs were left unattended. This poses an immediate health & safety risk to the children in care.
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Licensee has agreed to submit self certification with the plan attached. To LPA Hernandez Torres by 07/14/2021.
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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: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3