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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364808632
Report Date: 12/17/2021
Date Signed: 12/17/2021 12:54:44 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
11/30/2021 and conducted by Evaluator Kendal Zirbes
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20211130124945
FACILITY NAME:DURAN FAMILY CHILD CAREFACILITY NUMBER:
364808632
ADMINISTRATOR:DURAN, MONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 337-7739
CITY:LAKE ARROWHEADSTATE: CAZIP CODE:
92352
CAPACITY:14CENSUS: 14DATE:
12/17/2021
UNANNOUNCEDTIME BEGAN:
10:59 AM
MET WITH:Licensee, Monica Duran TIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility using a baby jumper item in a childcare home
INVESTIGATION FINDINGS:
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On December 17, 2021, Licensing Program Analyst (LPA) Kendal Zirbes conducted a follow-up complaint inspection to the Family Child Care and met with Licensee Monica Duran. The purpose of the inspection was to deliver the finding for the above stated complaint allegation. During the investigation, children, staff, and parents were interviewed. Facility file, records, and additional evidence was also reviewed.
Based LPAs observation, it was determined that the facility was using a baby jumper in the childcare home. On December 8, 2021 LPA observed Graco Children’s Doorway Jumpers in the living room. On December 8, 2021 at 9:45am LPA observed child 1 (C1) utilizing the doorway jumper and child 2 (C2) was utilizing another doorway jumper at 1:59pm. Licensee confirmed the doorway jumpers are being utilized in the family childcare home. Licensee stated the jumpers are safe since they were secured with additional hooks to wooden ceiling beams as opposed to a doorway.
Based on the information obtained, there is a preponderance of evidence to prove the facility was using baby jumper items in a childcare home. Therefore, the above allegation is substantiated. Appeal Rights were provided and discussed with the Licensee and deficiencies were cited. Continued on page two
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
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 12-CC-20211130124945
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: DURAN FAMILY CHILD CARE
FACILITY NUMBER: 364808632
VISIT DATE: 12/17/2021
NARRATIVE
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A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20211130124945
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: DURAN FAMILY CHILD CARE
FACILITY NUMBER: 364808632
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/17/2021
Section Cited
CCR
102417(g)(10)
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102417 (g)(10) Operation of a Family Child Care Home. A baby walker shall not be allowed on the premises of a family childcare home in accordance with Health and Safety Code Section 1596.846(b) and (c). This requirement was not met as evidence by:
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Per Licensee, the baby jumpers have not been utilized since December 8, 2021.
As of this inspection, the baby jumpers were removed per LPA's observation. No further action required.
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On December 8, 2021 LPA observed two children utilizing baby jumpers in the family childcare home. These items are prohibited per Section 1500.86 of Part 1500 of Title 16 of the Code of Federal Regulations. This poses a potential Health, Safety, or personal right risk to 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: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3