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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364843790
Report Date: 08/31/2023
Date Signed: 08/31/2023 01:51:43 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/27/2023 and conducted by Evaluator Babatunde Ibitoye
COMPLAINT CONTROL NUMBER: 12-CC-20230627151030
FACILITY NAME:BURRELL FAMILY CHILD CAREFACILITY NUMBER:
364843790
ADMINISTRATOR:BURRELL, TIERRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 362-3565
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:14CENSUS: 8DATE:
08/31/2023
UNANNOUNCEDTIME BEGAN:
01:11 PM
MET WITH:Burrell TierraTIME COMPLETED:
02:12 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1.Personal Right
2.Neglect/Lack of Supervision
3.Personal Right
4.Personal Right
5.Ratio
6.Personal Right
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 08/31/23 Licensing Program Analysts (LPA) Babatunde Ibitoye conducted a complaint investigation at the facility to deliver complaint investigation findings. Upon arrival, LPA met with Licensee Burrell Tierra During the visit, LPA observed 8 children in care with Licensee and Assistant .
During the investigation, LPA Ibitoye interviewed children, licensee, facility staff,Licensee spouse and parents of the program. As part of the investigation, LPA Ibitoye obtained the facilities children roster.
It was revealed during the course of the investigation that there was no witness to prove that allegations occurred. Therefore, the allegations have been found unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that all the allegations happened, Therefore the above allegations are Unsubstantiated.
An exit interview was conducted, and a copy of this report was provided to Licensee Burrell Tierra along with Notice of Site Visit and Appeal Rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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