364846156-12-1-2022-09-CC-AROS-CM6SDE-20221216124701

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364846156
Report Date: 12/01/2022
Date Signed: 12/01/2022 09:46:10 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/11/2022 and conducted by Evaluator Blanca Ruiz-Silva

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20220811084800

FACILITY NAME:	GREEN FAMILY CHILD CARE		FACILITY NUMBER:	364846156
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	12/01/2022
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Ebony Green and Essence Merriwether		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Uncleared adult living on day care premises

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Blanca Ruiz and Elyse Jones arrived at the facility to conclude an investigation regarding a complaint received concerning the above allegation, a prior inspection was made on 08/15/22. Present during this inspection was licensee, Ebony Green and licensee’s daughter (co-licensee) Essence Merriwether. The facility was toured, and census was taken.
Complainant reported that an uncleared adult is/was living on daycare premises. During the course of the investigation, interviews were conducted with staff present at the facility and pertinent parties to obtain additional information and/or to clarified facts related to the allegation.
LPA Ruiz investigated the allegation and gathered the following information:
It was alleged that on or about the middle of June and/or August the licensee allowed an uncleared adult male to be present and/or to reside at the facility while children were in care at the facility. Licensee denied the allegation and confirm that the adult in question used to reside on her property prior to licensee obtaining a license by Community Care Licensing (CCL); however, licensee confirm that she allowed this individual to utilize her address to establish residency and/or to receive mail.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 09-CC-20220811084800

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 364846156
	VISIT DATE: 12/01/2022

NARRATIVE

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Therefore, this individual obtained a California Driver License with her facility address during the transition of her processing her daycare license, but this individual does not reside at the facility. During the physical inspection at the facility, LPA observed male clothing and belongings; license explained that clothing belongs to a deceased family member and she wanted to conserve it. Licensee provided documentation to CCL under penalty of perjury denying any additional individual(s) residing on home and/or staying during daycare hours while children are in care. LPAs informed the licensee that all adults who work, reside or volunteer at the facility must receive a criminal record clearance/exemption prior to working, residing and/or volunteering at the facility.

After a thorough review of the information obtained, there is conflicting information obtained from pertinent parties. However, no additional witnesses nor additional evidence corroborate the allegation that the adult in question is physically present at the facility during business hours. Therefore, based on the information gather, there is not enough facts to corroborate the reported allegation. 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. Therefore, allegation is unsubstantiated at this time.

Exit interview conducted and report was reviewed with licensee, Ebony Green. Appeal rights were discussed, and a notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. This report must be available to the public for three years.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022

LIC9099 (FAS) - (06/04)

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