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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 103911016
Report Date: 03/18/2020
Date Signed: 03/18/2020 03:07:34 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/10/2020 and conducted by Evaluator Joseph Pacheco
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20200110084249

FACILITY NAME:GOMEZ, MA DEL FAMILY CHILD CAREFACILITY NUMBER:
103911016
ADMINISTRATOR:GOMEZ, MA DELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 289-3865
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:14CENSUS: 6DATE:
03/18/2020
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ma Del Gomez - LicenseeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
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9
Day care children are not being afforded dignity in their personal relationships.
INVESTIGATION FINDINGS:
1
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9
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11
12
13
On 3/18/2020, Licensing Program Analysts (LPAs) Joseph Pacheco and Diana Martinez conducted an unannounced complaint inspection at the Family Child Care Home (FCCH). LPA met with Spanish speaking Licensee, Ma Del Gomez. LPA Martinez provided translation. The purpose of the inspection was to deliver the finding for the above complaint allegation.

During the course of the investigation, LPA interviewed Licensee, day care staff, day care parents, Licensee's children and day care children. LPA attempted to interview Complainant but multiple phone calls were not returned. This agency has investigated the complaint alleging day care children are not being afforded dignity in their personal relationships. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2020
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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