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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153911167
Report Date: 06/08/2020
Date Signed: 06/09/2020 07:44:36 AM



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
06/02/2020 and conducted by Evaluator Caroline Harris
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20200602121141
FACILITY NAME:ARREDONDO, MICHELLE FAMILY CHILD CAREFACILITY NUMBER:
153911167
ADMINISTRATOR:ARREDONDO, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 298-2329
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:14CENSUS: 0DATE:
06/08/2020
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Michelle ArredondoTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared adult residing in home.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/8/2020, an unannounced complaint inspection was conducted today by Licensing Program Analysts (LPA's) Caroline Harris and Stefanie Galvan. LPA's met with the Licensee, Michelle Arredondo and her husband. Also present was the licensee's daughter in law, her boyfriend and the grandson, who were visiting. LPAs toured the facility both inside and outside and a census was taken. LPA's explained the above listed allegation to the licensee. The purpose of today’s visit was to open the complaint investigation. The investigation consisted of interviews with the licensee, inspection of all the rooms on the ground level, upstairs and the basement, as well as a facility records review. A copy of the roster was also received.
Although the allegation may have happened or is valid, based on statements received during the investigation, and the inspection of the premises, 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 is cited during today's visit. An exit interview with Licensee Michelle Arredondo was conducted. Appeal rights were discussed and given to licensee. A Notice of Site Visit is to be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2020
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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