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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020044
Report Date: 05/29/2024
Date Signed: 05/29/2024 05:36:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/10/2024 and conducted by Evaluator Franchesca White
COMPLAINT CONTROL NUMBER: 54-CC-20240110133851
FACILITY NAME:ALVAREZ LEIVA FAMILY CHILD CAREFACILITY NUMBER:
198020044
ADMINISTRATOR:ALVAREZ LEIVA,S & CARLOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 448-4169
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY:14CENSUS: 3DATE:
05/29/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Siomara Leiva - Alvarez, LicenseeTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of delivering the findings of the complaint received to the department on January 10, 2024 for the allegation of lack of supervision leading to the violation of personal rights. At the time of the visit there were 3 children present, 1 staff, and all adults in the home have current criminal background clearance.

In regards to the Personal Rights allegation of lack of supervision which resulted in children engaging in inappropriate interactions, this negligence of care resulted in the violation of a child’s personal rights while in care of the facility.
Therefore, based on the evidence, observations and interviews conducted by LPA White, and the investigation branch of the department, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, section 102423 (a)(1) is being cited on the attached LIC 9099D.
.................................................Report Continues 1 of 2 Pages..........................................................

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024
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 54-CC-20240110133851
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ALVAREZ LEIVA FAMILY CHILD CARE
FACILITY NUMBER: 198020044
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/28/2024
Section Cited
CCR
102423(1)(a)
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Each child receiving services from a family child care home shall have certain rights...the following:
(1) To be treated with dignity in his/her personal relationship with staff and other persons. The requirement was not met by evidence of:
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Licensee states that her and her assistant will watch the department issues videos on supervision, and provide a supervision plan to LPA White on or before the POC date.
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Based on observation, and interview, Licensee did not provide proper supervision that led to the personal rights of a day care child being violated which poses an immediate health and safety risk to persons 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: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 54-CC-20240110133851
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ALVAREZ LEIVA FAMILY CHILD CARE
FACILITY NUMBER: 198020044
VISIT DATE: 05/29/2024
NARRATIVE
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LPA White informed Licensee Siomara Leiva that a Non-Compliance Conference will be scheduled at a later date due to the severity of the substantiated allegation.

LPA White informed licensee Siomara Leiva, that this report dated 05/29/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA White informed licensee Siomara Leiva to provide a copy of this licensing report dated 05/28/24 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee, Siomara Leiva - Alvarez.


...........................Report Ends 2 of 2 Pages................................................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3