complaint·May 8, 2024

On 03/25/2024, LPA Chan made an unannounced visit to the facility for the purpose of initial investigation about a complaint received on 3/15/24. During the visit, LPA reviewed 15 children’s files (including newly enrolled children). It was discovered that none of the 15 child files had a signed Acknowledgement of Receipt of Licensing Report (LIC 9224) form for the licensing report dated 02/15/2024. On 03/25/24, Director, Aida King was interviewed, the director stated the facility did not provide the 02/15/24 licensing report LIC9099 and acknowledgement receipt LIC9224 to all infant families by the next business day. Director stated the facility sent a letter to the regional office requesting to hold providing LIC9224 to parents. On 03/25/24, LPA stated that licensing report LIC9099 and acknowledgement receipt LIC9224 dated 2/15/24 should be provided to authorized representatives for signature within 24hrs or the next business day the child is in school. On 5/8/24, LPA gathered documents such as, LIC9040 Children's Roster, Infant Sign in sheet for 5/8/24 as of 9:40am, facility enrollment list for infants. During today's visit, LPA reviewed 14 files without signed LIC9224. Based on records reviewed, and interview conducted, it has been determined that the facility did not provide a copy of the report dated 02/15/24 by the next business day to the parents/guardians of children currently enrolled and newly enrolled. The preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated. California Code of Regulations, Title 22, Health and safety code 1596.8595 (c) is being cited on the attached LIC 9099D and civil penalty assessed. Exit interview was conducted with Director Aida King. Notice of Site Visit was posted during the visit. Director was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above within 15 business days. Page 2 of 2