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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198009469
Report Date: 11/01/2023
Date Signed: 11/01/2023 10:24:37 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2023 and conducted by Evaluator Jeanette Estrada
COMPLAINT CONTROL NUMBER: 54-CC-20231027091758
FACILITY NAME:KING FAMILY CHILD CAREFACILITY NUMBER:
198009469
ADMINISTRATOR:KING, INGRIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 921-5489
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 3DATE:
11/01/2023
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Licensee Ingrid King TIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Facility is malodorous
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Jeanette Estrada and Angelica Wallin conducted an unannounced complaint inspection at the facility listed above. LPAs met with Licensee Ingrid King and explained the reason for the visit. LPAs observed three children in care during the visit.
Upon arrival LPAs smelled smoke in the home. Licensee admitted to smoking in the home before day care hours. Per Licensee, the hours of operation are 6AM to 6PM. Licensee stated she smokes before 6AM and in the late evening. Per Licensee, the home is aired out and ventilated by opening doors and windows. Although Licensee stated the facility is aired out, the smell of smoke remains.
Based on interview and observation, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated.One type B deficiency is being cited today in accordance with California Code of Regulations Title 22 102417(b) Operation of a family child care home.
Exit interview conducted with Licensee Ingrid King
_Continued on page 2_
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
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 3
Control Number 54-CC-20231027091758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: KING FAMILY CHILD CARE
FACILITY NUMBER: 198009469
VISIT DATE: 11/01/2023
NARRATIVE
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The Notice of Site Visit (LIC 9213) and the Appeal Rights were given and explained to the Facility Representative. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20231027091758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: KING FAMILY CHILD CARE
FACILITY NUMBER: 198009469
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2023
Section Cited
CCR
102417(b)
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102417(b) The home shall be kept...with ventilation for safety and comfort.
This requirement is not met as evidenced by:
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Licensee stated she will not smoke in the home and will stilll ventilate the facillity before and after. Licensee will provide a declaration with her statement.
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Based on interview and observation, although Licensee stated the home is ventilated after smoking, the scent of smoke remains. This is a potential risk to 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: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3