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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493009999
Report Date: 09/26/2024
Date Signed: 09/26/2024 05:57:16 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, 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
06/26/2024 and conducted by Evaluator Leticia Rosales
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240626165407
FACILITY NAME:CUEVAS, DIANA FCCHFACILITY NUMBER:
493009999
ADMINISTRATOR:CUEVAS, DIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 774-2318
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY:14CENSUS: 12DATE:
09/26/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Diana CuevasTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Infant sustained unexplained bruises.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Leticia Rosales-Meza conducted an unannounced subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with the Licensee. It has been alleged that an Infant sustained unexplained bruises, specifically that C1 sustained bruising on C1's right thigh and it’s from side to side.

During the initial Complaint-Investigation to the facility on 06/28/24, and a follow up Complaint-Investigation to the facility on 9/20/24, LPA met with Licensee on 06/28/24 to initiate the investigation by discussing the purpose of the inspection, conducted an interview with Licensee, Staff 1 S1), records were reviewed, and requested and received a facility roster of the children in care on 6/28/24 and 0/20/24.

Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
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 5
Control Number 01-CC-20240626165407
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: CUEVAS, DIANA FCCH
FACILITY NUMBER: 493009999
VISIT DATE: 09/26/2024
NARRATIVE
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Licensee acknowledged the bruising to C1’s thigh/leg, but denied the injuries were a result of staff conduct. According to Licensee and S1, C1 did not have existing bruising injuries when dropped off, and Licensee and S1 did not see or know exactly how C1 sustained the bruising. Licensee stated we always check the children when they arrive and even if they have one little mark or scratch, I ask the parents what happened to their child. Licensee stated I am sure C1 did not sustain any injuries while in my care, nor did we notice any bruising/marks prior. It wasn't until after leaving my house and after a few minutes later that C1's parent called me to go outside, and when I went outside to see C1, I did notice the marks on C1's leg. Licensee stated "I don't understand how those marks/bruising showed up all of a sudden, but I can assure you that if it occurred here, it was not due to an injury or any mistreat".

Based on available information, records reviewed and LPA observations, although C1 did sustain bruising on thigh/leg the cause of bruising is undetermined, therefore, the allegation is Substantiated. The following violations of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled. This report was reviewed and discussed with the Licensee, Diana Cuevas. Appeal Rights were provided.


The following violations of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. This report was reviewed and discussed with the Licensee. Appeal Rights were provided. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 01-CC-20240626165407
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: CUEVAS, DIANA FCCH
FACILITY NUMBER: 493009999
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/27/2024
Section Cited
CCR
102423(a)(2)
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Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

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Licensee stated she will speak with staff and she will complete a written statement detailing how she intends to make the environment even safer to prevent children from getting injured in any way and to check the children as they arrive for any injuries they may have at arrival and document it. LPA provided Regulations 102423 Personal Right.
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This requirement was not met as evidenced by: Based on interviews, records obtained, and observations, C1 did sustain bruising which was undetermined. This posed an immediate health, safety and/or personal rights risk to C1.







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Licensee stated she will submit her POC to the CCL by 09/27/24 via mail, email or fax.

Email: leticia.rosales@dss.ca.gov
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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: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/26/2024 and conducted by Evaluator Leticia Rosales
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240626165407

FACILITY NAME:CUEVAS, DIANA FCCHFACILITY NUMBER:
493009999
ADMINISTRATOR:CUEVAS, DIANAFACILITY TYPE:
810
ADDRESS:1737 EAST MADISON STREETTELEPHONE:
(707) 774-2318
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY:14CENSUS: 12DATE:
09/26/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Diana CuevasTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Licensee is not meeting day care infant's diapering needs.

Licensee is not allowing parents/guardian to enter the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Leticia Rosales-Meza made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with Licensee, Diana Cuevas. It was alleged that Licensee is not meeting day care infant's diapering needs, specifically that C1 was left soiled from 12:00pm to 3:00pm. It was that Licensee is not allowing parents/guardian to enter the facility, specifically that they don’t parents go inside the daycare.

During the initial Complaint-Investigation to the facility on 06/28/24, and a follow up Complaint-Investigation to the facility on 9/20/24, records were reviewed, and the LPA conducted interviews with the Licensee and Staff 1 (S). The Licensee stated denied the allegations and stated, "I have no issues of children getting diaper rashes while in my care, nor any parent complaining about a diaper rash. We change children's diapers constantly".

Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20240626165407
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: CUEVAS, DIANA FCCH
FACILITY NUMBER: 493009999
VISIT DATE: 09/26/2024
NARRATIVE
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Licensee stated during Covid, there were special rules that parents were not allowed inside, but after Covid, no special rules. Some parents are always rushed and don't want to come inside, they just pick up their child at the door and run off, but if a parent wants to come in, they are welcome all the time, no entry is denied.

Interviews were conducted with Parent 2 (P2) and Parent 3 (P3) on 9/11/24. Interviews and records reviewed do not corroborate with the allegations.

Based on interviews conducted, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are Unsubstantiated. There was no Title 22 deficiency cited based on the above findings. Exit interview conducted and report was reviewed and discussed with Licensee, Diana Cuevas. 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: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5