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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334842136
Report Date: 09/17/2024
Date Signed: 09/17/2024 03:57:10 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/23/2024 and conducted by Evaluator Jesse Gardner
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240823142743
FACILITY NAME:KELLEY FAMILLY CHILD CAREFACILITY NUMBER:
334842136
ADMINISTRATOR:MONICA KELLEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 657-9491
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY:14CENSUS: 0DATE:
09/17/2024
UNANNOUNCEDTIME BEGAN:
03:29 PM
MET WITH:Monica Kelley, LicenseeTIME COMPLETED:
04:05 PM
ALLEGATION(S):
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Licensee not living in daycare facility
INVESTIGATION FINDINGS:
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On 09/17/24 at 03:29 PM, Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to deliver the findings of the above allegation. LPA met with Licensee Monica Kelley and informed her of the purpose of this visit. During this investigation LPA conducted interviews with confidential witnesses and staff and obtained supportive documentation for review to assist with determining the findings for the above noted allegation. The following was determined.

It was alleged that the Licensee does not live at the facility. Interview with confidential witnesses revealed the Licensee has not lived in the facility since 02/2023. During an interview with Licensee, they confirmed they have not lived at the facility since approximately 02/2023 and lives and provides care and supervision to children at
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
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 5
Control Number 10-CC-20240823142743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KELLEY FAMILLY CHILD CARE
FACILITY NUMBER: 334842136
VISIT DATE: 09/17/2024
NARRATIVE
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another address. Based upon interviews with Licensee and confidential witnesses the allegation is Substantiated.

A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted where a copy of this report was reviewed with and provided along with copies of the LIC9099D, and Appeal Rights. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 10-CC-20240823142743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KELLEY FAMILLY CHILD CARE
FACILITY NUMBER: 334842136
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/01/2024
Section Cited
HSC
1596.78(d)
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General Provisions and Definitions: A small family daycare home or large family daycare home includes a detached single-family dwelling, a townhouse, a dwelling unit within a dwelling, or a dwelling unit within a covered multifamily dwelling in which the underlying zoning allows for residential uses. A small family daycare home or large family daycare home is where the daycare provider resides, and includes a dwelling or a dwelling unit that is rented, leased, or owned. This requirement was not being met as evidenced by:
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Licensee has submitted new application to be licensed at a new address.
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Based on Licensee’s disclosure that they no longer reside in the licensed home and that they would sometimes take children to their new residence to provide care and supervision. This poses a potential health and safety 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: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/23/2024 and conducted by Evaluator Jesse Gardner
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240823142743

FACILITY NAME:KELLEY FAMILLY CHILD CAREFACILITY NUMBER:
334842136
ADMINISTRATOR:MONICA KELLEYFACILITY TYPE:
810
ADDRESS:856 VOLANDE COURTTELEPHONE:
(951) 657-9491
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY:14CENSUS: 0DATE:
09/17/2024
UNANNOUNCEDTIME BEGAN:
03:29 PM
MET WITH:Monica Kelley, LicenseeTIME COMPLETED:
04:05 PM
ALLEGATION(S):
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Unqualified staff providing care and supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to deliver the findings of the above allegation. LPA met with Licensee Monica Kelley and informed her on the purpose of this visit. During this investigation LPA conducted interviews with Licensee, and confidential witnesses and obtained supportive documentation for review to assist with determining the findings for the above noted allegations. The following was determined.

It was alleged that the Licensee has unqualified staff providing care and supervision to children. Specifically, it was reported that on 08/14/2024, or 08/15/2024, Child #1 (C1) was being supervised by an unqualified staff. Additionally, it was reported that between 02/2023 – 05/2023, several unqualified staff were utilized to supervise
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20240823142743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KELLEY FAMILLY CHILD CARE
FACILITY NUMBER: 334842136
VISIT DATE: 09/17/2024
NARRATIVE
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children while the Licensee was away from the facility. 4 of 4 parent interviews stated the Licensee and her Assistant (S2) are the only ones who supervise children. Record review indicated the Licensee and S2 are qualified to provide care and supervision. C1’s parent, along with other parent interviews revealed the Licensee and S2 are the only staff they drop off or pick up their children from.

Thus, due to the conflicting information obtained through interviews conducted with Licensee, staff, witnesses and a review of evidence obtained, the allegation is Unsubstantiated.

A finding of UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where a copy of this report was reviewed with and provided along with a copy of the LIC811 (confidential names list), and Appeal Rights. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5