483009838-9-10-2021-01-CC-LLEI-C6TQH5-20210913121030

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483009838
Report Date: 09/10/2021
Date Signed: 09/10/2021 10:28:38 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2021 and conducted by Evaluator Kevin O'Connell

COMPLAINT CONTROL NUMBER: 01-CC-20210513125640

FACILITY NAME:	MCQUEEN, JACOYA FCCH		FACILITY NUMBER:	483009838
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	09/10/2021
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Jacoya McQueen, Licensee		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Licensee is not following the noted court order for a daycare child

Day care child is released to non-authorized family members.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Kevin O'Connell, made a subsequent complaint investigation visit and met with Licensee, Jacoya McQueen (LS) to deliver the findings regarding the allegations noted above. LPA Augustin previously met with LS on 05/19/21 to initiate the investigation by discussing the purpose of the visit, making observations, and obtaining a facility roster of the children in care. It was alleged that the Licensee is not following the noted court order for a daycare child and a day care child was released to non-authorized family members.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20210513125640

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: MCQUEEN, JACOYA FCCH	FACILITY NUMBER: 483009838
	VISIT DATE: 09/10/2021

NARRATIVE

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LS denied the allegations, acknowledging that she was required to comply with court order(s), and claiming that she never released any child(ren) to any person who was not authorized for pick up or was not listed on a child’s Identification and Emergency Information form (LIC 700). LS did convey an incident in which she was hesitant to allow an adult to enter the facility to pick up C1 due to that adult’s actions surrounding the current custody situation but further claimed that she never said that the adult could not visit the facility.

Through the course of the investigation starting from 05/19/21 through 08/20/21, LPA interviewed LS, three adults, and five parents and reviewed documents. Some children were not verbal, too young to interview, or not available to be interviewed. Multiple statements provided by adults and parents did not report concern(s) or any incident(s) of LS not following an issued court order(s), as well as any incident(s) of LS releasing any child to an unauthorized representative. One statement reported LS releasing a child to a non-authorized family member, however; the child’s Identification and Emergency Information confirmed that the family member was authorized to pick up the child.

Based on the investigation, there’s not a preponderance of evidence to support the allegations and therefore; the allegations are unsubstantiated. This report was discussed and reviewed with LS and an Exit interview was conducted with LS. Notice of Site Visit shall be posted for 30 days. There were no title 22 deficiencies cited during this visit. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC9099 (FAS) - (06/04)

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