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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494524
Report Date: 05/09/2024
Date Signed: 05/09/2024 11:07:46 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, 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
03/08/2024 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20240308142810
FACILITY NAME:PEREZ FAMILY CHILD CAREFACILITY NUMBER:
197494524
ADMINISTRATOR:PEREZ, JOHANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 304-6887
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY:14CENSUS: 5DATE:
05/09/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Johana Perez, LicenseeTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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9
Licensee threatened day care child in care.
Licensee vaped in the presence of day care children in care.
INVESTIGATION FINDINGS:
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5
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On 05/09/2024 @9:00 AM, Licensing Program Analysts (LPAs) Miriam Cohen and Devon Carus conducted an unannounced visit and met and informed Johanna Perez, licensee, of the report findings against the alleged complaints: * Licensee threatened day care child in care.
* Licensee vaped in the presence of day care children in care.
Upon arrival, LPAs observed licensee providing care for five children.
After conducting interviews and receiving pertinent information with licensee, parents and day care children, visual observation, and consultation with management, the allegation of personal rights could not be corroborated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore, the above allegation is determined to be UNSUBSTANTIATED.
An exit interview was conducted with the above items discussed with the licensee. A copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
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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