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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198015325
Report Date: 06/16/2021
Date Signed: 06/16/2021 03:52:17 PM

Unsubstantiated


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
04/06/2021 and conducted by Evaluator Fabiola Vasquez
COMPLAINT CONTROL NUMBER: 33-CC-20210406103144
FACILITY NAME:FLORES FAMILY CHILD CAREFACILITY NUMBER:
198015325
ADMINISTRATOR:FLORES, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 599-1468
CITY:LA VERNESTATE: CAZIP CODE:
91750
CAPACITY:14CENSUS: 5DATE:
06/16/2021
UNANNOUNCEDTIME BEGAN:
02:34 PM
MET WITH:Maria Flores, LicenseeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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9
Care provider inappropriately disciplined day care children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility on 06/16/21 via telephone due to COVID-19 and precautionary measures. LPA spoke with Maria Flores, Licensee. LPA identified herself and stated the purpose of the contact is to provide the findings for the above allegation. The call was transferred
to facetime to complete the virtual tele-inspection tour of the facility.

Census: 5 Staff: 3

Pertaining to the allegations that, “Care provider inappropriately disciplined day care children.”
During the course of the investigation, LPA conducted interviews with RP, C1 C2, C3, P1, P2, S2, S3, S4 and licensee. LPA obtained documents in the form of a children’s roster including all the names of the children that attended with in the last 3 years.

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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
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 2
Control Number 33-CC-20210406103144
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: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 198015325
VISIT DATE: 06/16/2021
NARRATIVE
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Due to inconsistent statements provided by all the parties interviewed there were no disclosures made regarding the allegation. The allegation has been determined to be UNSUBSTANTIATED. A finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit phone interview has been conducted with Licensee Maria Flores, Appeal Rights were verbally explained and provided to Licensee as well. A copy of this report (LIC 9099) along with the Appeal Rights LIC (9058) has been signed by LPA Vasquez. This report along with the Appeal Rights will be scanned via e-mail to the Licensee, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report, and the Appeal Rights will be mailed, and the Licensee agrees to sign the bottom of each page of the LIC 9099 and return the originals to LPA Vasquez in-person or via U.S. Mail. A Notice of Site Visit was not provided to Licensee since a physical inspection was not conducted.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
LIC9099 (FAS) - (06/04)
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