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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197700105
Report Date: 03/09/2022
Date Signed: 03/09/2022 09:44:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/11/2022 and conducted by Evaluator Isabel Ortega
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20220111135546
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197700105
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
03/09/2022
UNANNOUNCEDTIME BEGAN:
02:46 PM
MET WITH:Virginia MartinezTIME COMPLETED:
03:56 PM
ALLEGATION(S):
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Allegation #2 Personal Rights: Licensee uses unusual form of punishment with children in care
INVESTIGATION FINDINGS:
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On March 09, 2022, Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced complaint inspection on the above allegation to deliver findings. LPA disclosed the purpose of inspection and was granted entry by Assistant who guided LPA on a tour of the family child care home. During initial entry, Licensee was not present at the facility and 6 children were present. Licensee was conducting child pick ups and arrived at about 4.00 P.M.

Based on observations, interviews conducted and documentation obtained, Allegation: Personal Rights: Licensee uses unusual form of punishment with children in care. Interviews disclosed children being placed on high chairs restrained when not listening. There were also disclosures children are placed in an off limits room with lights off when children do not wish to nap. The preponderance of evidence standard has been met, therefore the above allegation is found Substantiated. California Code of Regulations, Title 22, Division 12 Personal Rights a Type A violation is being cited.

Continuation page............................
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/11/2022 and conducted by Evaluator Isabel Ortega
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20220111135546

FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197700105
ADMINISTRATOR:MARTINEZ, VIRGINIAFACILITY TYPE:
810
ADDRESS:12526 OSBORNE STREETTELEPHONE:
(818) 939-1869
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY:8CENSUS: 8DATE:
03/09/2022
UNANNOUNCEDTIME BEGAN:
02:46 PM
MET WITH:Virginia MartinezTIME COMPLETED:
03:56 PM
ALLEGATION(S):
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9
Allegation #3 Personal Rights: Licensee yells at day care children
INVESTIGATION FINDINGS:
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On March 09, 2022, Licensing Program Analyst (LPA) Isabel Ortega conducted a subsequent investigation for the purpose of concluding the investigation for the above allegation and deliver findings. LPA discuss with Licensee Virginia Martinez the complaint findings.

During the course of investigating, LPA Ortega conducted interviews with licensee, Staff and children. There were no disclosure made towards allegation: Licensee yells at day care children. It was revealed and observed licensee has a distinct voice that may seem loud according to licensee it may be medical allergies that cause the raspy voice. Therefore the complaint investigation is unsubstantiated, Based on the information it is determined that there is not a preponderance of evidence to prove that the alleged violations occurred. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

A copy of this report and a notice of site visit and appeal rights were provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 12-CC-20220111135546
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197700105
VISIT DATE: 03/09/2022
NARRATIVE
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A finding of substantiated means that allegation is valid because the preponderance of the evidence standard has been met. This facility was cited today in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes.

The facility was cited Type A according to the California Code Title 22 Regulations. See Facility Evaluation Report LIC 9099D for deficiencies.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An exit interview conducted, appeal rights discussed, and a copy of this report was provided to licensee.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 12-CC-20220111135546
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197700105
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/09/2022
Section Cited
CCR
102423(a)(4)
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(a) Each child receiving services shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive
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Licensee will immediately cease utilizing high chairs to restrain children and provide other options. licensee will not use off limits room for punishment. Licernsee will take course on how to redirt children with challenging behaviors and submit a written summary of what was learned to the Palmdale RO. by email by 3/28/22.
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nature, interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning this requirement was not met by interview disclosures. licensee is restraining children on high chairs and using off limits room to punish children when not wanting to nap or not listening. This poses an immediate 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: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4