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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197414238
Report Date: 12/29/2023
Date Signed: 12/29/2023 10:25:08 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/20/2023 and conducted by Evaluator Elicia Calvillo
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230920163023
FACILITY NAME:PARRILLO FAMILY CHILD CAREFACILITY NUMBER:
197414238
ADMINISTRATOR:PARRILLO, DANIELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 739-1048
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:14CENSUS: 0DATE:
12/29/2023
UNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Danielle Parrillo, LicenseeTIME COMPLETED:
10:25 AM
ALLEGATION(S):
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Adult in the home does not have proper evidence of a current tuberculosis clearance.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced complaint inspection on 12/29/2023 to deliver findings for the above allegation. LPA arrived at the facility at 09:37 AM and met with Danielle Parrillo, Licensee who guided LPA on tour of facility. There were 0 children and 0 staff upon arrival.

Information provided by the Reporting Party indicates that an adult in the home does not have proper evidence of a current tuberculosis clearance.

The initial investigation was conducted by LPA Maria Rendon who conducted a visit to the facility on 9/27/2023. During the 09/27/23 visit by LPA Rendon, interviewed Licensee, reviewed staff files, reviewed Criminal Clearance Record, obtained a copy of the roster, and requested copies of Tuberculosis (TB) Test for adults living in the home. LPA Rendon reminded Licensee that all adults living in the home must obtain Criminal Clearance Record and TB test
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2023
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 58-CC-20230920163023
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PARRILLO FAMILY CHILD CARE
FACILITY NUMBER: 197414238
VISIT DATE: 12/29/2023
NARRATIVE
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On 9/27/2023, LPA Rendon was not provided with copies of the TB clearance for Adult #1 (A1) and Licensee disclosed that Adult #2 (A2) would be returning to live in the home and will require TB clearance. LPA Rendon arrived to the facility at 8:42AM on 09/27/23 and left the facility at 10:45AM. At 6:22PM, Licensee emailed LPA Rendon, confirmation that Licensee did not have proof of TB clearance for A1 and A2 and an appointment to complete the TB test was scheduled for A1 A2. LPA Rendon did not receive proof of TB clearance for A1 and A2 until 10/01/2023.

Based on LPA’s observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 Chapter 1, 102369 (b), (9) Application for Initial License, is being cited on the attached deficiencies page.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 58-CC-20230920163023
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PARRILLO FAMILY CHILD CARE
FACILITY NUMBER: 197414238
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/29/2023
Section Cited
CCR
102369(b)(9)
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102369 Application for Initial License,(b) The applicant shall provide all of the following information at the time of submission of the application:
(9) Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care.


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A1 and A2 completed a TB Test on 10/01/2023.
Going forward to ensure TB Testing is completed prior to entry to the child care facility. Will keep an ongoing log of TB testing. Will provide log of current adults in the facility by 1/19/2024.
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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: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3