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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393622862
Report Date: 02/06/2025
Date Signed: 02/06/2025 10:37:50 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
12/18/2024 and conducted by Evaluator Janie Davis
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20241218090034
FACILITY NAME:LEYVA, CAROLINEFACILITY NUMBER:
393622862
ADMINISTRATOR:CAROLINE LEYVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 601-2601
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:14CENSUS: 2DATE:
02/06/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Caroline LeyvaTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
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9
Licensee yanked a child in care.
Licensee allowed an adult to smoke in the home.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Janie Davis and Lauren Scott met with licensee, Caroline Leyva, to deliver the findings of the complaint investigation regarding the above allegations.
During the course of the investigation, LPA Davis conducted interviews, and obtained information pertaining to allegation. It was alleged that Licensee allowed an adult to smoke in the home and yanked a child. Based on information provided by licensee, no residents participate in smoking or physical punishment. Interviews conducted with parents revealed they have not smelled smoke, nor had they expressed concerns regarding licensee's care to the children.
Based on the information obtained throughout the course of this investigation, and conflicting information obtained from parents and licensee, the above allegation could not be substantiated or dismissed. 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.
Exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
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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