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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197409174
Report Date: 02/04/2025
Date Signed: 02/05/2025 10:18:55 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/27/2025 and conducted by Evaluator Brittany Lovest
COMPLAINT CONTROL NUMBER: 30-CC-20250127111022
FACILITY NAME:FOSTER FAMILY CHILD CAREFACILITY NUMBER:
197409174
ADMINISTRATOR:FOSTER, GLENDA V.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 921-8753
CITY:REDONDO BEACHSTATE: CAZIP CODE:
90278
CAPACITY:14CENSUS: 5DATE:
02/04/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Alessandra Sanchez-Assistant TIME COMPLETED:
12:05 PM
ALLEGATION(S):
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Personal Rights: Licensee does not ensure day care children are immunized prior to admission
INVESTIGATION FINDINGS:
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On 02/04/2025 at 8:30 a.m., Licensing Program Analyst (LPA)s, Brittany Lovest and Cristina Castellanos conducted an unannounced complaint investigation regarding the above allegations. LPA Lovest and LPA Castellanos met with assistant A. Sanchez. A. Sanchez states Licensee Glenda Foster is out of town and will return today.

LPAs requested the following documents: children’s roster and children’s files. Additionally, LPAs interviewed facility staff, S1.

During the file review 2 out of 9 children’s files did not meet the immunization requirement for childcare home admission. Additionally, LPAs observed the PERSONAL BELIFIEFS AFFIDAVIT for immunization signed by parents on the back of the California School Immunization Record PM 286 (1/99) for C6 and C7.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Brittany Lovest
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
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 30-CC-20250127111022
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 197409174
VISIT DATE: 02/04/2025
NARRATIVE
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Based on record review it was found that the Licensee does not ensure day care children are immunized prior to admission, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

There was one deficiency cited during today’s visit in accordance with the California Code of Regulations, Title 22, Division 12, and Chapter 3. See LIC 9099-D for additional information.

An exit interview was conducted, and Plans of Correction were reviewed. A copy of this report and appeal rights were discussed and left with the Licensee. A notice of site visits was given and must remain posted for 30 days. Failure to comply with posting requirements shall results in an immediate civil penalty of $100.


SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Brittany Lovest
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20250127111022
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FOSTER FAMILY CHILD CARE
FACILITY NUMBER: 197409174
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/10/2025
Section Cited
CCR
102418(a)
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102418 Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.
This requirement is not met as evidenced by:
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The licensee shall provide proof of immunization records for C6 and C7 to LPA via email by POC due date. Licensee is aware that C6 and C7 can not return until immuization a records are provided.
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Based on record review and interview, it was found that the Licensee does not ensure day care children are immunized prior to admission, 2 out of 9 children's file did not have immunization records, which poses/posed a potential health, safety or personal rights risk to persons in care.
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LPA reminded licensee PERSONAL BELIFIEFS AFFIDAVIT for immunization is no longer accepeted/honored in California.
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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: Claudia Escobedo
LICENSING EVALUATOR NAME: Brittany Lovest
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3