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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 293624312
Report Date: 01/16/2024
Date Signed: 01/16/2024 10:57:05 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/09/2023 and conducted by Evaluator Matthew Gallo
COMPLAINT CONTROL NUMBER: 03-CC-20231109105252
FACILITY NAME:AGUILAR, JUANFACILITY NUMBER:
293624312
ADMINISTRATOR:AGUILAR, JUANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 414-6786
CITY:TRUCKEESTATE: CAZIP CODE:
96161
CAPACITY:14CENSUS: 12DATE:
01/16/2024
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Juan AguilarTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Daycare child sustained unexplained injuries while in care
INVESTIGATION FINDINGS:
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At 9:50am on 1/16/2023, Licensing Program Analyst (LPA) Matthew Gallo met with licensee Juan Aguilar to deliver findings of the investigation into the above allegation. Upon arrival, LPA observed a total census of 12 children, consisting of 9 preschool children and 3 infants. Three adult assistants were also present during the visit.

It was alleged that a daycare child sustained unexplained injuries while in care, pertaining to bruising discovered on the hips and rear end of a child. Throughout the investigation process, LPA conducted observation, record review, and interviewed licensee, assistants, and parents. Through the course of interviews, LPA determined that staff found the bruising in the course of changing diapers and reported their observations to the child's parent. LPA observations of the facility and interviews with staff and additional parents did not provide evidence to corroborate an allegation that the injury took place at the child care facility. In interview, the child's parent expressed a belief that the injury could possibly have been sustained when playing at home on a slide. (Report continues on 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
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 2
Control Number 03-CC-20231109105252
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: AGUILAR, JUAN
FACILITY NUMBER: 293624312
VISIT DATE: 01/16/2024
NARRATIVE
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Due to lack of corroborating evidence and the existence of alternative explanations of the injury, the allegation that a child sustained unexplained injuries while in care is UNSUBSTANTIATED, meaning that although the allegation might have happened or is valid, there is not a preponderance of evidence to prove it.

Exit interview conducted and report was reviewed with facility representative Juan Aguilar. A notice of site visit was given and must remain posted for 30 days. Appeal rights provided.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2