065406379-12-10-2021-13-CC-MAVS-C9S398-20211216170244

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 065406379
Report Date: 12/09/2021
Date Signed: 12/10/2021 10:55:33 AM

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
09/30/2021 and conducted by Evaluator Laura Chavez

PUBLIC

COMPLAINT CONTROL NUMBER: 13-CC-20210930153333

FACILITY NAME:	RIVERA, ANA FAMILY CHILD CARE HOME		FACILITY NUMBER:	065406379
ADMINISTRATOR:	RIVERA, ANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 473-3207
CITY:	WILLIAMS	STATE: CA	ZIP CODE:	95987
CAPACITY:	14	CENSUS: 0	DATE:	12/09/2021
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Ana Rivera		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff medication accessible to day care child

INVESTIGATION FINDINGS:

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On 12/9/2021 at 10:50am, Licensing Program Analyst (LPA) Laura Chavez conducted an unannounced follow up complaint inspection to the facility to deliver complaint findings. LPA met with Licensee Ana Rivera. It was alleged that staff medication was accessible to a child in care, specifically that a bottle of Claritin allergy medication was found in Child #1's backpack.

The licensee and her assistant were interviewed on 10/5/2021 and denied the allegation. The licensee and her assistant whom reside in the home stated that no one in the home takes Claritin. The licensee said she picked up Child #1 on 9/30/2021 from preschool along with her backpack. The licensee said all backpacks and personal items brought into the home by children in care are placed in the plastic storage containers with lids which are located in each child's cubbie located outside of the playroom. The licensee said nothing is removed from the plastic storage container until a child is picked up at the end of the day.

Report Continued: See LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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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Control Number 13-CC-20210930153333

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: RIVERA, ANA FAMILY CHILD CARE HOME	FACILITY NUMBER: 065406379
	VISIT DATE: 12/09/2021

NARRATIVE

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Three parent interviews and four child interviews conducted on 10/13/2021 and 11/8/2021 corroborate that medication has not been observed to be accessible to children in care. Interviews conducted on 11/5/2021 with Adults #1, #2, and #3 whom also reside in the home confirmed that no one in the home take Claritin allergy medication or seen medication left out accessible to children. Adults #1, #2, and #3 stated all medication, prescribed and over the counter is kept in a locked cabinet.

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.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

LIC9099 (FAS) - (06/04)

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