013414016-3-4-2021-02-CC-SJON-BYXSRM-20210309130630

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013414016
Report Date: 03/04/2021
Date Signed: 03/04/2021 05:02:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2020 and conducted by Evaluator Diana Campos

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20201105105706

FACILITY NAME:	LOPEZ, ROSA & ALEGRIA, ADAN		FACILITY NUMBER:	013414016
ADMINISTRATOR:	LOPEZ, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 261-2776
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	14	CENSUS: 4	DATE:	03/04/2021
		UNANNOUNCED	TIME BEGAN:	04:20 PM
MET WITH:	Rosa Lopez		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Personal Rights: Licensee inappropriately disciplined child in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Diana Campos made an unannounced tele-visit call with licensee Rosa Lopez due to COVID-19 restrictions for the purpose of delivering the findings of a complaint investigation. Present today were licensee, licensee's assistant, and 4 children in care consisting of 2 infants and 2 school-age children. During the course of the investigation, interviews were conducted. It was alleged that Licensee inappropriately disciplined child in care by throwing a small toy plate at her back in reprimand for having hit another child with the same plate first. Licensee stated she was not present the day the alleged incident occurred. During the investigation, there were no other disclosures made about children being hit as a form of discipline. Based on the investigative findings, it cannot be determined whether or not the allegation occurred. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore the allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2021

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 1