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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393621811
Report Date: 10/20/2022
Date Signed: 10/20/2022 01:12:11 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/09/2022 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20220909144121
FACILITY NAME:BALMORES, FE GRACEFACILITY NUMBER:
393621811
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
10/20/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Fe Grace BalmoresTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Personal Rights-Staff left child in soiled clothing for extended period of time
INVESTIGATION FINDINGS:
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On Thursday, October 20, 2022, at 12:00PM ,Licensing Program Analyst (LPA) Elvira Sierra met with Licensee, Fe Grace Balmores to deliver findings for the above allegation. Present in the facility was Licensee supervising one daycare child.

It was alleged that staff left child in soiled clothing for extended period of time. Throughout the investigation, LPA interviewed the Reporting Party (RP), Licensee, parents and records were reviewed. LPA learned through interviews that diapers are checked many times throughout the day such as before or after napping, before going outdoors or when Licensee can smell that the diaper needs changing. Licensee stated that parents provide diapers and wipes and she request from parents an extra set of clothing or two in case child needs to be change. Parents interviewed also did not disclose any information of evidence to support the above allegation.

Report continues on subsequent page 809C--
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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 53-CC-20220909144121
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: BALMORES, FE GRACE
FACILITY NUMBER: 393621811
VISIT DATE: 10/20/2022
NARRATIVE
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Based on the information obtained; 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 finding is UNSUBSTANTIATED.

An exit interview was conducted in which the report and Appeal of Rights were reviewed and provided to Licensee,, Fe Grace Balmores. Notice of Site Visit posted and should remain posted for 30 days.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2