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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364808573
Report Date: 08/12/2024
Date Signed: 08/12/2024 05:38:57 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/20/2024 and conducted by Evaluator Taityana Benson
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20240520163658
FACILITY NAME:WHITE FAMILY CHILD CAREFACILITY NUMBER:
364808573
ADMINISTRATOR:WHITE, JACQUELINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 899-6697
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:14CENSUS: 6DATE:
08/12/2024
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH: Jacqueline White, LicenseeTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Admission Agreement: Provider did not allow parent to pick up child from care.
Personal Rights: Provider provides expired food to children.

INVESTIGATION FINDINGS:
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On August 12, 2024, Licensing Program Analysts (LPAs) Taityana Benson and Aman Lama arrived at the facility to conclude the investigation regarding the above allegation, a previous inspection was conducted on May 29, 2024. LPAs met with Licensee, Jacqueline White and conducted a tour of the facility inside and outside. During the investigation, interviews were conducted with pertinent parties and documentation was collected.

On May 20, 2024, a complaint was received alleging provider did not allow parent to pick up child from care.

Per interviews conducted, and information gathered, the investigation revealed on May 13, 2024, a daycare child was dropped off at the facility by parent “A” during the 7 o’clock, a.m. hour. Shortly after, parent “B” arrived at the facility and removed the daycare child from the facility. It was disclosed that parent “B” placed the daycare child in their vehicle.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Taityana Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
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 09-CC-20240520163658
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WHITE FAMILY CHILD CARE
FACILITY NUMBER: 364808573
VISIT DATE: 08/12/2024
NARRATIVE
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Immediately after the daycare child was placed in the vehicle, the licensee removed the daycare child from the vehicle, preventing parent “B” from departing with daycare child. The licensee stated due to the court documents in the child’s file provided by parent “A”, parent “B” forfeited their right to have the daycare child in their care during the 7 o’clock a.m. hour. After carefully reviewing the certified court ordered child custody and child visitation documents, parent “B” visitation schedule concludes at 8:00 a.m., every other Monday. It should be noted, Monday, May 13, 2024, is within parent “B” alternating weekend schedule. Therefore, this incident resulted in the licensee not allowing parent “B” to pick up the daycare child.

LPAs observed that expired food in the garage refrigerator. LPAs observed all 3 gallons of milk in the refrigerator were expired. The dates on two of the gallons was 08-06-24, and the other one 07-14-24. LPAs also observed multiple “Honest” juice boxes with a “best if used by” date of 04-01-24. Additionally, there was a bag of “LandO’Frost” turkey breast meat slices with a label of “sell by” 08-02-24. LPAs also found mustard with a date of 07/26/2024.

Based on interviews with pertinent parties and records obtained throughout the investigation, the department has determined the preponderance of evidence standard has been met, therefore the allegation of admission agreement is found to be SUBSTANTIATED. See LIC9099-D for deficiency cited per California Code of Regulations Title 22, Division 12.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and report was reviewed with Licensee, Jacqueline White.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Taityana Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 09-CC-20240520163658
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: WHITE FAMILY CHILD CARE
FACILITY NUMBER: 364808573
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
08/26/2024
Section Cited
CCR
102419(a)(6)
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Admission Procedures and Parental and Authorized Representative's Rights 102419(a)(6):To request in writing that a parent not be allowed to visit or take a child from the family child care home, provided the custodial parent has shown a certified copy of a court order pursuant to Health & Safety
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Licensee agrees to submit a written statement of understanding of Title 22 Regulation Admission Procedures and Parental and Authorized Representative's Rights 102419(a)(6), &establish a plan of action to ensure admission agreements are maintained. Licensee agrees to provide a
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Code Section 1596.857.This requirement is not met as evidenced by:Based on interviews, video footage, licensee’s own omission, &records obtained throughout the investigation, licensee did not allow a child in care to be taken from the facility by their parent during the time of their court ordered
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copy of the written statement and plan of action to LPA via email by close of business on 08/26/2024.



custody agreement.
Type B
08/26/2024
Section Cited
CCR
102423(a)(b)
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Personal Rights 102423(a)(b)To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.LPAs observed that expired food in the garage refrigerator. LPAs observed all 3 gallons of milk in the refrigerator were expired as of 08-06-24 & 07-14-24.
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During the inspection, LPAs observed licnesee changing out the groceries and confirmed that they had been replaced before the end of the day.
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LPAs also observed multiple “Honest” juice boxes with a “best if used by” date of 04-01-24. Additionally, there was a bag of “LandO’Frost” turkey breast meat slices with a label of “sell by” 08-02-24. LPAs also found mustard with a date of 07/26/2024.
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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: Aaron Ross
LICENSING EVALUATOR NAME: Taityana Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5