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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 525408080
Report Date: 02/07/2023
Date Signed: 02/07/2023 02:18:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/28/2022 and conducted by Evaluator Bianca Mendez
COMPLAINT CONTROL NUMBER: 13-CC-20221028101021
FACILITY NAME:SURBER, TRINA FAMILY CHILD CARE HOMEFACILITY NUMBER:
525408080
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
02/07/2023
UNANNOUNCEDTIME BEGAN:
01:57 PM
MET WITH:Trina SurberTIME COMPLETED:
02:17 PM
ALLEGATION(S):
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Licensee speaks inappropriately in the presence of day care children.
INVESTIGATION FINDINGS:
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On 2/7/23 at 1:57pm LPA Mendez conducted a subsequent visit for the purpose of delivering complaint findings. It was alleged that licensee speaks inappropriately in the presence of day care children.

The licensee was interviewed on 11/7/22 at 9:00am and denied the allegation, stating that she does not speak inappropriately to day care children. LPA Mendez asked if licensee she has every spoken to children inappropriately, in which licensee responded no. LPA Mendez asked licensee if she has sweared around children in which she stated no she has never sweared around children.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
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 13-CC-20221028101021
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: SURBER, TRINA FAMILY CHILD CARE HOME
FACILITY NUMBER: 525408080
VISIT DATE: 02/07/2023
NARRATIVE
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LPA Mendez interviewed staff (S1) on 1/19/23, LPA Mendez asked S1 how long they had been working with licensee and how often do they work there in which S1 replied that they have been working since licensee opened and come in at least once or twice a week. LPA Mendez asked S1 if they had witnessed licensee speaking inappropriate to children in care in which S1 stated no.

LPA Mendez interviewed parents (P1-P5) on 12/13/22 and 12/15/22.LPA Mendez asked parents if they had witnessed licensee talk inappropriately to their children or any children in care. Five out of five parents stated no they had not witnessed licensee talking to children inappropriately. LPA Mendez asked parents P1-P5 if they had any concerns regarding supervision in which they four out of five stated no.

LPA Mendez attempted to interview children (C1-C5) on 2/1/23 and was able to interview one of five children. LPA Mendez asked C1 one if licensee has ever left them alone without an adult in which C1 stated no. LPA Mendez asked C1 if licensee has said anything mean to them or any other children, in which C1 shook their head no.
During today’s visit facility was toured and LPA observed 2 children in care.

Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. An exit interview was conducted. The Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2