115407245-7-23-2019-13-CC-EVIA-BEFRWP-20190726132326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 115407245
Report Date: 07/02/2019
Date Signed: 07/23/2019 12:10:32 PM

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
05/08/2019 and conducted by Evaluator David Wilson

PUBLIC

COMPLAINT CONTROL NUMBER: 13-CC-20190508172053

FACILITY NAME:	DIAZ, ROSA FAMILY CHILD CARE HOME		FACILITY NUMBER:	115407245
ADMINISTRATOR:	DIAZ, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 988-9212
CITY:	ORLAND	STATE: CA	ZIP CODE:	95963
CAPACITY:	14	CENSUS:	DATE:	07/02/2019
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Rosa Diaz		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Lack of supervision

INVESTIGATION FINDINGS:

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A follow-up complaint inspection was conducted from 12:00pm to 12:15pm on 07/23/19 by Licensing Program Analyst (LPA) David Wilson. This is an amended report, and replaces the report dated 7/2/19. It was alleged that there was a lack of supervision whereby children left facility unattended on two occasions, and were not being supervised by an adult: It was alleged that on 4/16/19 a young child (C1) was observed outside at a neighbor’s home without supervision, and a witness (A1) returned C1 to the facility where there was no adult present. A teenager (C4) claimed to be responsible for supervising the children. It was also alleged that on 05/08/19 two children (C1 and C2) were observed in a neighbor’s yard without supervision. The licensee did not appear to be home, and C1 and C2 were being supervised by C4.

The licensee was interviewed on 5/9/19, 6/20/19, 7/2/19, and 7/15/19 and denied the allegation. The licensee stated that C1 and C2 were in care on 04/16/29 and 05/08/19 and that she was home providing supervision during both incidents. The licensee stated that the children were never out of sight by her or her assistant.
Continued on next page...

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019

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 4

Control Number 13-CC-20190508172053

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: DIAZ, ROSA FAMILY CHILD CARE HOME	FACILITY NUMBER: 115407245
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/02/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 07/08/2019 Section Cited HSC 1597.58(C)(2)	1 2 3 4 5 6 7	Absence of supervision, including, but not limited to, a child left unattended and a child left alone with a person under 18 years of age. This requirement was not met as evidenced by: interviews, record reviews and observation the licensee failed to supervised when children left facility property unsupervised.	1 2 3 4 5 6 7	On 07/08/19 licensee provided written understanding of Title 22 section 102417. On 06/27/19 licensee provided pictures of adequate safety door knobs and latches to ensure children cannot readily open doors to leave the facility unsupervised (LPA observed at facility on 07/02/19). On 07/08/19 licensee provided a weekly child day care schedule.
	8 9 10 11 12 13 14		8 9 10 11 12 13 14	This schedule listed days, hours, children and supervisors as a weekly written planned schedule of the day care operation. A $500 civil penalty is assessed for absence of supervision.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 13-CC-20190508172053

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: DIAZ, ROSA FAMILY CHILD CARE HOME	FACILITY NUMBER: 115407245
	VISIT DATE: 07/02/2019

NARRATIVE

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Continued from page one...

During the course of the investigation, the LPA interviewed witnesses and obtained video and photos from the incidents on 04/16/19 and 05/08/19. The photos and video taken on 5/8/19 show C1, C2, C3 and C4 all outside of a neighbor’s house. The licensee and/or the assistant are not present in the photos.

On 7/2/19 the licensee was shown a photo of the incident on 5/8/19. The licensee identified the children in the photos as C1, C2, and C4. The licensee stated that she was not aware of the incident, and asked C4 about it. C4 said she didn’t tell the licensee for fear of getting in trouble. The licensee stated that she was at home in the kitchen when the incident occurred. C4 was interviewed and stated that she has never been left at the home without adult supervision. The licensee’s assistant (S1) was interviewed and stated that no children ever left the facility property.

On 05/09/19 while LPAs Wilson and Stefanie Whitlow were at the facility, C1 exited from the home and was immediately found in the driveway by the licensee and brought back inside.

During the investigation, interviews were conducted with other witnesses, children, and parents of the children in care Interviews were not able to corroborate that the licensee ever left the facility while day care children were there without adult supervision; however, it was corroborated that children left the facility property and crossing the public road into one or more neighbor’s property in the immediate neighborhood without adult supervision. Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D and a civil penalty assessed.

Licensee understands this citation is a Type A deficiency. For a Type A deficiency licensee must provide this report to the current authorized representatives of children enrolled and to any future authorized representatives for one year from this date. Licensee must place in each child’s file a LIC9224 Acknowledgment of Receipt of Licensing Reports with the children’s authorized representatives signature.
Appeal rights were provided and exit interview conducted. The Notice of Site Visit form must be posted for 30 days from this date of inspection.
See LIC9099D ...

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 13-CC-20190508172053

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: DIAZ, ROSA FAMILY CHILD CARE HOME	FACILITY NUMBER: 115407245
	VISIT DATE: 07/02/2019

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	This is an amended report, and replaces the report dated 7/2/19. This page is no longer needed for narrative and comments.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019

LIC9099 (FAS) - (06/04)

Page: 4 of 4