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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 033622932
Report Date: 09/22/2021
Date Signed: 09/22/2021 12:12:09 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/05/2021 and conducted by Evaluator Aruna Sridharan
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20210805143301
FACILITY NAME:CABLE, CHONGFACILITY NUMBER:
033622932
ADMINISTRATOR:CABLE,CHONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 304-8815
CITY:IONESTATE: CAZIP CODE:
95640
CAPACITY:14CENSUS: 3DATE:
09/22/2021
UNANNOUNCEDTIME BEGAN:
10:46 AM
MET WITH:Chong CableTIME COMPLETED:
11:47 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights (X2) : Infant's diapering needs were not met and appropriate accommodations were not provided.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/22/2021 Licensing Program Analyst (LPA) Aruna Sridharan met with licensee Chong Cable to to deliver the complaint findings for the above allegations. It was alleged that infant's diapering needs were not met. The child had dry poop in the diaper area. LPA Sridharan interviewed licensee and multiple parents of infants. Three of three parents stated they have no concerns regarding diaper needs of their infants. The second allegation was about not providing appropriate accommodations to infant. The infant had cat hair in the mouth. During the interview, licensee stated that she places the infant on the area rug in the living room. Licensee explained she vacuums frequently to keep the area rug clean. LPA Sridharan conducted inperson inspection to observe the facility, the area rug for cat hair and found the floors clean.
The information gathered throughout the course of this investigation was not sufficient enough to support or dismiss the above allegations. Therefore, the finding for the above two allegations were determined to be UNSUBSTANTIATED. An exit interview was conducted in which the report was reviewed and discussed with licensee. Appeal rights were discussed and a printed version was given to licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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