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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073409133
Report Date: 09/01/2023
Date Signed: 09/01/2023 03:52:34 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/13/2023 and conducted by Evaluator Indira Loza
COMPLAINT CONTROL NUMBER: 02-CC-20230713084108
FACILITY NAME:CABRERA BALMORI, SOFIAFACILITY NUMBER:
073409133
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
09/01/2023
UNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Sofia CabreraTIME COMPLETED:
04:01 PM
ALLEGATION(S):
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Personal Rights - Licensee speaks inappropriately to children in care
Personal Rights - Licensee uses multiple forms of unusual punishment on daycare children
Personal Rights - Licensee yells at children in care
Personal Rights - Licensee placed child on a time out for an extended period
INVESTIGATION FINDINGS:
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On September 1, 2023, at 1:34pm Licensing Program Analyst (LPA) Indira Loza and Licensing Program Manager (LPM) Mayla Mendoza met with Licensee Sofia Cabrera Balmori to continue the complaint Investigation for the above allegations. The facility was toured for a health and safety check. During the investigation staff, parent, and children interviews were conducted and records were reviewed.

Interviews indicated that the Licensee would speak inappropriately to a child and using profanity. Interviews also indicated the Licensee used forms of punishment such as feeding hot sauce to a child, placing children in a high chair for timeout, locking children in the backyard, and giving a child a cold shower. Interviews also indicated that the Licensee would yell and use profanities towards the children. Additionally, interviews revealed that the Licensee placed children on time out in a high chair and in the basement.

Therefore, the preponderance of evidence standard has been met and the allegation is SUBSTANTIATED.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023
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 02-CC-20230713084108
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CABRERA BALMORI, SOFIA
FACILITY NUMBER: 073409133
VISIT DATE: 09/01/2023
NARRATIVE
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California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

One Type A deficiency is being cited during today's inspection. The Licensee must provide a copy of this report to all parents of children currently enrolled, and the parents of newly enrolled children in the next 12 months. In addition, Form LIC 9224 (Acknowledgment of receipt of Licensing Reports) must be signed by each parent and placed in each child's file.

Report reviewed with Licensee Sofia Cabrera Balmori.


Report and Appeal Rights provided.
Notice of Site Visit must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20230713084108
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CABRERA BALMORI, SOFIA
FACILITY NUMBER: 073409133
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/05/2023
Section Cited
CCR
102423
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Personal Rights: (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. This Requirement was not
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The Licensee shall watch the Personal Rights video on the CDSS website and write a statement on what was learned. This must emailed to the LPA by September 5, 2023.
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met as evidenced by: Based on interviews it was determined that the Licensee inappropriately speaks to children, yell and curse, place on time out for a long time, and use multiple forms of punishment; which poses an immediate risk to the health, safety, and personal rights to children in care.
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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: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3