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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198021130
Report Date: 06/04/2024
Date Signed: 06/05/2024 08:43:08 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 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
03/18/2024 and conducted by Evaluator Mary Silva
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240318124041
FACILITY NAME:ROBLES FAMILY CHILD CAREFACILITY NUMBER:
198021130
ADMINISTRATOR:MARIA ROBLESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 531-6983
CITY:AZUSASTATE: CAZIP CODE:
91702
CAPACITY:14CENSUS: 1DATE:
06/04/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee Maria RoblesTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Infant sustained unexplained injuries while in care
Licensee did not arrange medical treatment for infant
Licensee did not practice safe sleep procedure
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Silva conducted an unannounced site inspection to present the findings of the above complaint allegations. Licensing staff met with licensee Maria Robles to whom the reason for the visit was explained. Licensee provided a tour of the facility. Present during the inspection was Licensee Maria Robles,assistant Alfredo Robles and 1 child.

Complainant Alleged
Infant sustained unexplained injuries while in care.
Licensee did not arrange medical treatment for infant.
Licensee did not practice safe sleep procedure.

During this investigation, LPA obtained a copy of the facility roster, reviewed file for child #1 and child #2, obtained parent contract/enrollment packet, written statement from licensee, copy of police report, verification of child #1 medical visits along with photographs of facial abrasions. ______Page 1____
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
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 5
Control Number 33-CC-20240318124041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ROBLES FAMILY CHILD CARE
FACILITY NUMBER: 198021130
VISIT DATE: 06/04/2024
NARRATIVE
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LPA captured photographs of three pets enclosed in a dog runner, photographs of the playrooms/napping room, living room, and photographs of ointment applied to facial abrasions child #1 sustained. LPA conducted interviews with reporting party, licensee, licensee’s assistant, parents of children in care and other possible witnesses.

Regarding the allegation: infant sustained unexplained injuries while in care. Licensee reported to department incident occurred on 03/15/24 at 2:30pm in the napping room. Per licensee child #1 and child #2 were in the napping room laying down on the carpet, their diaper was changed a bottle was given to child #1 and child #2, per licensee child #2, dropped the bottle, rolled to the right side, and scratched child #1 in the face. Licensee stated to be kneeling in front of children when the incident occurred. Child #1 sustained multiple facial abrasions to the right cheek, left cheek, chin, nostril and bruise on the forehead. Based on police report, incident occurred in a crib where child #1 and child #2 were laying together, child #2 scratched child #1. Another account reported incident occurred while licensee turned away to get a diaper while child #1 and child #2 were laying on the floor in the napping room. Licensee stated to have cameras facing the front yard with no audio and no cameras are installed inside the facility.

Regarding the allegation: licensee did not arrange medical treatment for child #1. Licensee stated to have applied “Antibiotic Pain Relief” ointment to child #1’s right cheek, left cheek, forehead, and chin without the consent of parent. Licensee stated incident occurred at approximately 2:30pm, parent was notified of incident between 5:20pm-5:30pm during the time children were picked up.

Regarding the allegation: licensee did not practice safe sleep procedures. During department interviews a disclosure was made on one occasion an infant fell asleep on a stroller before being transferred to a crib. In addition, licensee confirmed 15-minute sleep logs were not maintained for safe sleep procedures.

Based on interviews and disclosures made during the department investigation, the preponderance of evidence and the standard has been met, therefore, the three allegations are found to be substantiated. California Code of Regulations (Title 22 Division & Chapter), are being cited on the attached deficiencies page LIC 9099-D.

_________________________Page 2__________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 33-CC-20240318124041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ROBLES FAMILY CHILD CARE
FACILITY NUMBER: 198021130
VISIT DATE: 06/04/2024
NARRATIVE
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Upon receipt of this report, the licensee shall post any licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will provide copies to the parents of the children in care for up to one year. A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was explained and provided to the Director.

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

Exit interview conducted with Licensee, Maria Robles.
____________________Page 3______________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 33-CC-20240318124041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ROBLES FAMILY CHILD CARE
FACILITY NUMBER: 198021130
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/05/2024
Section Cited
CCR
102423(a)(4)
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102423(a)(4) Personal Rights
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. These rights include, but are not limited to, the following:(4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
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Licensee declared to notify child's representatives within 15 minutes of any injuries. In addition Licensee declared to view video on the personal rights of in child care www.ccld.childcarevideos.org and submit a summary to LPA.
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This requirement was not met as evidenced by: Child sustained unexplained injuries during the time of care. This was an immediate risk to the health and safety of children in care.
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Type A
06/05/2024
Section Cited
CCR
102423(a)(2)
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(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. These rights include, but are not limited to, the following:(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. These rights include, but are not limited to, the following:(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
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Licensee declared to refrain from utilizing a stroller to place an infant to sleep, will on use a crib or play yard. Licensee declared to view video on safe sleep practices www.ccld.childcarevideos.org and submit a summary to LPA.
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This requirement was not met as evidenced by: Licensee did not practice safe sleep procedures. This was an immediate risk to the health and safety of 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: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20240318124041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ROBLES FAMILY CHILD CARE
FACILITY NUMBER: 198021130
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/05/2024
Section Cited
CCR
102423(a)
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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. These rights include, but are not limited to, the following:To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
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Licensee declared to refrain from applying any type of oinment to a child without consent. Licensee declared to view video on a child's personal rights. www.ccld.childcarevideos.org and submit a summary to LPA.
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This requirement was not met as evidenced by: Licensee did not arrange medical treatment and applied oinment without consent of the parent. This was an immediate risk to the health and safety of 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: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5