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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 367700245
Report Date: 01/26/2024
Date Signed: 01/26/2024 12:02:18 PM

Unsubstantiated


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
11/01/2023 and conducted by Evaluator Justeene Tamayo
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20231101140041
FACILITY NAME:BURRELL-BENTLEY FAMILY CHILD CAREFACILITY NUMBER:
367700245
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
01/26/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:LaToya Burrell-Bentley,Licensee TIME COMPLETED:
12:10 PM
ALLEGATION(S):
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 Allegations:
Neglect/Lack of Supervision: On or about October 2023, daycare child sustained unexplained injuries while in care

Reporting Requirements: Licensee did not ensure reporting requirements were followed
INVESTIGATION FINDINGS:
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On 01/26/2024, Licensing Program Analyst (LPA) Justeene Tamayo met licensee Latoya Burrell-Bentley for the purpose of concluding the investigation concerning the above complaint allegations. LPA toured the facility and observed 2 infants and 1 school age child in care, along with the licensee.
The investigation consisted of interviews with staff, children, and other relevant complaint parties. The interviews conducted revealed the following evidence:

Allegation #1: During interviews with the licensee and child #4, it was revealed licensee was providing care to child #1 and child #4. Licensee was conducting a learning activity with the day care children. Child #1 was playing in their kiddie chair and started leaning back. The licensee instructed child #1 to sit properly,however child #1 leaned back, and fell on their back. The incident happened very fast,not allowing the licensee to prevent the incident from occurring. The licensee provided first aid and applied ointment to child #1’s back and neck. At the end of the day, the licensee notified child #1’s guardian of the incident. Concerning the injuries to child #1’s knee, there is no corroboration that the incident occurred at the facility.
Please see LIC9099-C for Continuation Page.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
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 2
Control Number 12-CC-20231101140041
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: BURRELL-BENTLEY FAMILY CHILD CARE
FACILITY NUMBER: 367700245
VISIT DATE: 01/26/2024
NARRATIVE
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Allegation #2: During an interview with licensee, it was disclosed that licensee notified child #1’s guardian of the incident where child #1 sustained a scratch on their back and neck.

Based on the information provided, the allegations of Neglect/Lack of Supervision and Reporting Requirements are rendered unsubstantiated based on inconsistent statements. 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 allegation occurred.

An exit interview was conducted, a copy of this report, appeal rights, and a notice of site visit report were provided to the facility.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2