<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393622672
Report Date: 03/11/2022
Date Signed: 03/11/2022 12:41:36 PM

Substantiated


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
03/07/2022 and conducted by Evaluator Christopher Jackson
COMPLAINT CONTROL NUMBER: 53-CC-20220307153632
FACILITY NAME:DE TORRES GOMEZ, CELINAFACILITY NUMBER:
393622672
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
03/11/2022
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Celina De Torres-GomezTIME COMPLETED:
12:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unsecured weapon in the home
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/11/22 Licensing Program Analysts (LPAs) Jackson and Hernandez, along with Licensing Program Manager (LPM) Denton, met with licensee Celina De Torres-Gomez to deliver the findings for the complaint allegation: “Unsecured weapon in the home.” During the investigation, statements taken corroborated that the facility failed to appropriately secure the weapon according to Title 22 regulations. This agency has investigated the complaint allegation. Based on statements taken, we have found that the complaint was SUBSTANTIATED: meaning that the allegation is valid because the preponderance of the evidence standard has been met.

Title 22 Deficiencies have been cited on the subsequent 9099-D page of this report. Upon receipt of a Type A citation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility for the next 12 months. As a result of the Type A citation a civil penalty in the amount of $500.00 will be assessed today.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
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-20220307153632
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: DE TORRES GOMEZ, CELINA
FACILITY NUMBER: 393622672
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2022
Section Cited
CCR
102417(4)(A)
1
2
3
4
5
6
7
Regulations state, storage areas for poisons, firearms and other dangerous weapons shall be locked. This regulation was not met as evidenced by on 03/07/22, a weapon was observed siting out in the home. This poses an immediate health and safety risk to the children in care.
1
2
3
4
5
6
7
The weapon will be secured with a chamber lock and the ammunition will be stored in separate lock boxes. In the alternative the weapon will be removed from the home. An immediate civil penalty will be assessed.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2