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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483009483
Report Date: 07/03/2024
Date Signed: 07/03/2024 12:05:09 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/21/2024 and conducted by Evaluator Cindy Castro
COMPLAINT CONTROL NUMBER: 01-CC-20240321112918
FACILITY NAME:HERNANDEZ, LORENA FCCHFACILITY NUMBER:
483009483
ADMINISTRATOR:HERNANDEZ, LORENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 712-1498
CITY:VALLEJOSTATE: CAZIP CODE:
94591
CAPACITY:14CENSUS: DATE:
07/03/2024
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Lorena HernandezTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not prevent children from harming another child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 07/03/24, Licensing Program Analyst (LPA) Cindy Castro, made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with the Licensee (L1), Lorena Hernandez. It has been alleged that Licensee did not prevent children from harming another child in care.
LPA, previously conducted inspections on 03/27/2024 to initiate the investigation and met with the Licensee (L1) to discuss the allegations, conduct interviews, make observations, and request documents.

During the investigation, LPA conducted interviews with the Licensee (L1), two staff members (S1-S2), two parents (P1-P2) & three children (C1-C3) from 03/27/2024 to 07/03/2024. Some children were not verbal, too young to interview, or did not qualify to be interviewed. L1 denied allegations and stated that mother of C1 refuses to communicate with her and that it is the father of C1 whom she communicated with. L1 further stated that she spoke with C1’s father about an incident that occurred, in which L1’s son threw a toy egg that hit C1. Furthermore, L1 added that she treats all children the same. Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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 01-CC-20240321112918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: HERNANDEZ, LORENA FCCH
FACILITY NUMBER: 483009483
VISIT DATE: 07/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Both S1 and S2 denied allegations. S1 stated that if a child hits another child staff call that child’s attention. S1 admitted that there was an incident in which his son threw a toy egg while he was supervising the children outside. S1 further added that the toy egg hit C1 on the head and S1 could not prevent it. S1 stated that he did not observe any bruising or redness on C1 and comforted C1. S1 stated that when parents pick up their child, staff will tell them what happened. S2 stated, “Children play, things happen and sometimes the children throw things”. S2 reported that she heard about the toy egg incident and that same week C1 had a scratch on her nose and that C1 told her it was L1’s son who scratch C1. S2 stated that she did not hear or observe the children fighting. S2 further added that she mentioned to C1’s mother about scratch on nose. S2 stated that when incidents occur L1 will be the one to talk to parents and share important information.

According to LPA observations on 03/27/2024 and 07/03/2024, the facility had staff caring for and supervising the children.

Children's interviews did not corroborate allegations. In addition, Parent (P2), father of C1 stated that L1 had spoken to him about incidents with toy egg and water bottle, letting him know that they were accidents. P1 stated that L1 told her that she would check on the incidents that occurred C1. P1 admitted to being in a hurry when picking up C1. P1 also stated that she was told about the scratch on the nose by S2. P1 also stated that L1 has been “acting weird and avoids her” since a prior incident occurred with C1 back in February 2024.

Licensee(L1) reported Unusual Incident involving C1 to the Department back in February 2024 and it was previously addressed.

Based on the information gathered during this investigation, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the allegations occurred and therefore are determined to be unsubstantiated. There were no Title 22 deficiencies cited. This report was reviewed and discussed with Licensee, Lorena Hernandez. Appeal rights were provided. Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2