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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493010732
Report Date: 02/26/2025
Date Signed: 02/26/2025 10:49:16 AM

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
01/15/2025 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20250115125218
FACILITY NAME:ESCOBEDO, MAYRA FCCHFACILITY NUMBER:
493010732
ADMINISTRATOR:ESCOBEDO, MAYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 852-9185
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY:14CENSUS: 2DATE:
02/26/2025
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Mayra EscobedoTIME COMPLETED:
11:03 AM
ALLEGATION(S):
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Infant sustained unexplained injuries in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Amy Strother made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with the Licensee, Mayra Escobedo (L1). It has been alleged that an infant (C1) sustained an unexplained injury while in the licensee's care.

During the initial investigation visit on 01/22/25, LPA requested and received a current roster of children in care, interviewed the Licensee (L1) and reviewed photo records. L1 denied the allegation stating that although she did observe scratches on C1’s armpit on 12/23/24 and scratches or a rash on the back of C1’s neck on 01/14/25, she was unaware of C1 being injured while in her care and notified C1’s parent of the marks observed on C1’s neck at pick up time. LPA was unable to qualify any children to be interviewed, due to their young ages.

Continue LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
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-20250115125218
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: ESCOBEDO, MAYRA FCCH
FACILITY NUMBER: 493010732
VISIT DATE: 02/26/2025
NARRATIVE
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LPA conducted interviews with four adults, Adult 2 – Adult 5 (A2-A5) between 02/19/25 and 02/21/25. Interviews with adults, A2-A5 gave corroborating statements, stating that they are very happy with the care provided by Mayra (L1), that L1 is very communicative about their child’s day, and that they feel their children are safe in L1’s care and have never experienced any unexplained injuries of their children. A2 specifically stated that L1 has called her to ask about a bruise L1 noticed on her child’s face, inquiring if A2 was aware of it. A2 confirmed with L1 that her child was playing with their sibling at home and hit their head, resulting in a bruise. A2 said she appreciated that L1 was so attentive. A3 stated that their child had not sustained any injuries in L1’s care. A5 stated that L1 will text or send photos during the day if any little injury occurs. Although LPA received photo evidence on 01/16/25, 01/22/25 and 01/29/25, showing that C1 had red marks near their armpit and on the back of their neck, there is not a preponderance of evidence to prove that the marks/injuries occurred in L1’s care.

Based on interviews conducted, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that an alleged violation occurred, therefore the allegation is UNSUBSTANTIATED.

There were no Title 22 deficiencies cited during today's inspection.


This report was reviewed and discussed with the Licensee, Mayra Escobedo.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
LIC9099 (FAS) - (06/04)
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