<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197492775
Report Date: 02/02/2022
Date Signed: 03/29/2022 11:23:21 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, 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
01/28/2022 and conducted by Evaluator Meghan McGee
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220128083716
FACILITY NAME:ARDON FAMILY CHILD CAREFACILITY NUMBER:
197492775
ADMINISTRATOR:ARDON, CHANELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 422-9469
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY:14CENSUS: 5DATE:
02/02/2022
UNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Alexis Ardon, StaffTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Reporting Requirements
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Meghan McGee conducted an unannounced complaint inspection to Ardon Family Child Care on 2/2/2022 at 11:27am. Upon arrival, LPA McGee met Alexis Ardon and explained the purpose of the inspection. LPA observed 5 children in care with 2 staff.

LPA McGee interviewed the licensee, staff and children, during the interview licensee self-admitted that she did not report cases of hand, foot and mouth and COVID-19 positive to the department as required. Based on the disclosure the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations Section 101229 is being cited on the attached LIC 9099-D page.

Exit interview was conducted and a copy of the report was provided. Appeal rights were reviewed and provided. A plan of correction was discussed and provided to the Licensee.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Meghan McGee
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022
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 2
Control Number 30-CC-20220128083716
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: ARDON FAMILY CHILD CARE
FACILITY NUMBER: 197492775
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/09/2022
Section Cited
CCR
102416.2(b)(3)(C)
1
2
3
4
5
6
7
102416.2 Reporting Requirements (b) The licensee shall report to the Department any of the events... that occur during the operation of the family child care home (3)(C) Any unusual incident or child absence that threatens...health or safety of any child.
This requirement is not met as evidence by:
1
2
3
4
5
6
7
Licensee has knowledge of reporting to licensing any unusual incident reporting by phone within 24 hrs of occurrence and written report to be submitted within 7 days. Licensee agrees to adhere to these reporting requirements.
8
9
10
11
12
13
14
Based on observations and interviews, the licensee stated they did not report hand, foot and mouth and COVID-19 positive case to CCL.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Maureen Neal
LICENSING EVALUATOR NAME: Meghan McGee
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2