Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198018116
Report Date: 11/20/2017
Date Signed 11/21/2017 11:20:07 AM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/17/2017 and conducted by Evaluator Betty Bell
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20171117121332
FACILITY NAME:MONTES FAMILY CHILDCAREFACILITY NUMBER:
198018116
ADMINISTRATOR:MONTES, PAULAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 520-2558
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY:14CENSUS: 9DATE:
11/20/2017
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Licensee Paula Montes (Zavalza)TIME COMPLETED:
07:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Overcapacity
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced Complaint visit was conducted on this date by Licensing Program Analyst (LPA) Betty Emiko Bell. Upon arrival, LPA was greeted and let into the facility by Licensee Paula Montes (Zavalza), who was with her assistant and 11 children, including her own 11 year-old child and a 12 year-old child. The remaining 9 children are ages: 8, 6, 5, 5, 5, 3, 3, 2, 1. Licensee's adult daughter arrived at around 3:00 P.M.

During today's visit, an informal interview was conducted with licensee and documentation was seen and photos were taken of: the Child Care Facility Roster (LIC 9040); the "Enrollment Renewal Report (10/01/17-09/30/18)"; a copy of the yellow sheet of the "Options for Learning-Food Program Visit Form" dated 10/12/17; and sign in/out sheets for the month of October 2017.


Continued on 9099-C


Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Betty BellTELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2017
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 4
Control Number 33-CC-20171117121332
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTES FAMILY CHILDCARE
FACILITY NUMBER: 198018116
VISIT DATE: 11/20/2017
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Upon receipt, the Licensee shall post the Notice of Site Visit and the Licensing report. This report and the Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100 civil penalty. A copy of this report shall be provided to the parents/guardians of the children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parents/guardians of any children newly enrolled at the facility for the next 12 months. The LIC 9224 Acknowledgement of Receipt of Licensing Reports must be maintained in each child's file immediately upon receipt from the parent.

An exit interview has been conducted with, and a copy of this report has been signed by and provided to Licensee Paula Montes-Zavalza. Appeal Rights and procedures were provided and explained to Licensee as well.

SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Betty BellTELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 33-CC-20171117121332
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTES FAMILY CHILDCARE
FACILITY NUMBER: 198018116
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/22/2017
Section Cited
CCR
102416.5(f)
1
2
3
4
5
6
7
STAFFING RATIO AND CAPACITY
The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.

-On 10/12/17, licensee was out of ratio for approximately fifty (50) minutes, from
1
2
3
4
5
6
7
Licensee has agreed to no longer enroll more than fourteen (14) children. Also, licensee will amend her contract so that drop-ins will need to give 24 hour notification and that children who have not attended for three weeks will be automatically disenrolled. A blank copy of the amendment to the contract will be
8
9
10
11
12
13
14
2:30-3:20 P.M. Though Licensee disenrolled 5 children on 10/13/17, she currently has nineteen (19) children enrolled.
8
9
10
11
12
13
14
provided to CCL by the COB on 11/22/17.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Betty BellTELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2017
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 33-CC-20171117121332
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTES FAMILY CHILDCARE
FACILITY NUMBER: 198018116
VISIT DATE: 11/20/2017
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
-Pertaining to the allegation that "Licensee is operating over capacity":

Based upon licensee's own admission and on documentation provided, on 10/12/17, licensee had seventeen (17) children in care. Based upon the Child Care Facility Roster, licensee has nineteen (19) children enrolled, of which approximately five are drop-in. Based upon the "Enrollment Renewal Report (10/01/17-09/30/18)," there were twenty-one children enrolled from 10/01/17-10/13/17. The yellow sheet of the "Options for Learning-Food Program Visit Form" dated 10/12/17 documented that licensee had "more kids in care than permitted by license" (though an exact number was not written, and the amount of time for which licensee was overcapacity was not documented). Sign in/out sheets which the licensee keeps on her own will, were provided for the month of October 2017. Sign in/out sheets were not provided for four children and two of the children for whom they were provided did not have the time they were signed out documented. Based upon approximate times of arrival and departure for the four for whom sign in/out sheets were not provided and based upon approximate departure times for the two who were signed out but for whom sign out times were not documented, licensee was over capacity for approximately fifty (50) minutes on 10/12/17. Licensee surmised that she was over capacity for approximately forty (40) minutes.

The question of children who are over the age of ten (10) was brought up. Licensee had four children over the age of ten (10) who were present. However, based upon the "Policy and Procedures" Manual, if "the child cannot come and go as he/she pleases and the parents pay for and/or expect child care services," the child, regardless of age, counts in capacity.

During today's visit, LPA provided Licensee with a printout of Section 102416.5 "Staffing Ratio and Capacity."

Thus, based upon licensee's admission and documentation provided by licensee, the preponderance of evidence standard has been met. Therefore, the allegation that "Licensee is operating over capacity," has been found to be Substantiated. A finding of Substantiated means that the allegation has been found to be valid because the preponderance of the evidence standard has been met. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 6 Continuing Requirements, Section 102416.5 "Staffing Ratio and Capacity," is being cited on the attached LIC 9099 D page. A Type A citation has been cited. A Type A citation means that the deficiency poses an immediate risk to the health and safety of the children involved.
SUPERVISOR'S NAME: Cassandra CooperTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Betty BellTELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2017
LIC9099 (FAS) - (06/04)
Page: 4 of 4