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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197495061
Report Date: 02/07/2023
Date Signed: 02/07/2023 11:11:06 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
01/06/2023 and conducted by Evaluator Adrian Risher
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20230106090551
FACILITY NAME:DIXON FAMILY CHILD CAREFACILITY NUMBER:
197495061
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
02/07/2023
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Tabina Dixon, LicenseeTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Other:Licensee is not residing in the licensed family child care home
INVESTIGATION FINDINGS:
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On 2/7/2023, Licensing Program Analyst (LPA) Adrian Risher, conducted a subsequent complaint visit regarding the above-mentioned allegation. Upon arrival, LPA met with Tabina Dixon, Licensee. LPA explained the purpose of the inspection. LPA observed 8 children in care.

On 10/14/2022, ESCCRO received a cross report stating that there was an open complaint filed against the licensee at her resource family home. On 10/20/2022, Information was obtained that the licensee does not reside in the family child care home.

On 1/10/2023, LPA Risher conducted the initial visit. During the visit, LPA Risher conducted an interview with the Licensee. Licensee reported she has a resource family home located at a different address. Licensee confirmed her primary residence is the resource family home.
Substantiated
Estimated Days of Completion: 40
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
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 30-CC-20230106090551
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: DIXON FAMILY CHILD CARE
FACILITY NUMBER: 197495061
VISIT DATE: 02/07/2023
NARRATIVE
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Based on Ms. Dixon’s admission, there is a is a preponderance of evidence to prove the allegation of Licensee not residing in the home is SUBSTANTIATED. Licensee was issued a Type B citation on 2/7/2023 (see LIC9099-D for details).

Exit interview was conducted and report was provided to Tabina Dixon, Licensee. Appeal rights will be provided.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20230106090551
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: DIXON FAMILY CHILD CARE
FACILITY NUMBER: 197495061
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/20/2023
Section Cited
HSC
1596.78(a)
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1596.78 family day care home
(a) "Family day care home" means a home that regularly provides care, protection, and supervision for 14 or fewer children, in the provider's own home, for periods of less than 24 hours per day, ...
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Based on the plan created during the Noncompliance Conference, Licensee has started the process to transfer her RFA to the licensed family child care home address within 30 days.
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This requirement was not met as evidenced by: Licensee reporting that her primary residence is her resource family home which is located at a different address.
This poses a potential risk to the health and safety of the 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: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3