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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376628583
Report Date: 05/22/2023
Date Signed: 05/26/2023 03:26:43 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2023 and conducted by Evaluator Edgar Campana
COMPLAINT CONTROL NUMBER: 20-CC-20230516112610
FACILITY NAME:CHEMSI, MOUNIA FAMILY CHILD CAREFACILITY NUMBER:
376628583
ADMINISTRATOR:MOUNIA CHEMSIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 988-6622
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:14CENSUS: 13DATE:
05/22/2023
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Mounia ChemsiTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Licensee operates beyond the terms and conditions of the license
INVESTIGATION FINDINGS:
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On 05/22/2023 at 10:45 AM, Licensing Program Analyst (LPA) Edgar Campana, conducted an Inital 10-day complaint investigation regarding the above allegation. LPA rang door bell and observed that Licensee's spouse walked out of the side door with an infant. LPA rang door bell again and was met by Licensee, Mounia Chemsi and was allowed into facility. Present was an assistant and 12 daycare children. Including the infant who was being removed from facility at time of LPA's arrival, the total number of children was 13. LPA reviewed children's records and confrimed that no school-aged children were present, placing the facility out of ratio, therefore the above allegation is SUBSTANTIATED. LPA informed Licensee to provide a copy of this licensing report dated 05/22/2023 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report reviewed with Licensee, Mounia Chemsi. Copy of report, Appeal Rights, and notice of site visit provided to Licensee. *This is an amended version of a report created on 05/22/23*
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023
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 20-CC-20230516112610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CHEMSI, MOUNIA FAMILY CHILD CARE
FACILITY NUMBER: 376628583
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/26/2023
Section Cited
HSC
1597.465(a)
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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met:
(a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
This requirement was not met as evidenced by:
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During course of inspection visit, an infant was removed from facility,which brought the census down to 12 and ratio was restored. LPA provided Licensee with a capacity regulations visual aid and a copy of HSC section 1597.465
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Based on LPA observations and record review, Licensee did not comply with the above regulation as there were 13 children present, of whom none are attending kindergarten or elementary or are at least 6 years old, which poses an immediate health and safety risk to children in care.
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Licensee stated that she will review capacity and ratio regulations and will provide a written statement to Licensing outlining her understanding of regulations by COB 05/26/2023.

*This is an amended version of a report that was created on 05/22/23*
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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: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3