191806680-9-2-2021-54-CC-VCOK-C74QMK-20210922121738

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191806680
Report Date: 09/02/2021
Date Signed: 09/02/2021 09:56:25 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/20/2021 and conducted by Evaluator Jeanette Estrada

COMPLAINT CONTROL NUMBER: 54-CC-20210720171018

FACILITY NAME:	DIAZ, MARIA AND IBOA, JORAM FAMILY DAY CARE		FACILITY NUMBER:	191806680
ADMINISTRATOR:	DIAZ, MARIA AND IBOA/JORAM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 264-0340
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY:	14	CENSUS: 5	DATE:	09/02/2021
		UNANNOUNCED	TIME BEGAN:	09:19 AM
MET WITH:	Licensees Maria Diaz and Joram Iboa		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Daycare child was inappropriately touched while in care

INVESTIGATION FINDINGS:

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Licensing program analyst (LPA) Jeanette Estrada conducted an unannounced complaint investigation for the purpose of delivering findings for the above allegation. LPA met with Maria Diaz & Joram Iboa, Licensees, who gave LPA a tour of the facility. There were 5 Children with 2 staff present.
During the investigation, interviews with witnesses were conducted by Community Care Licensing Investigator, Tifannie Brunelli. Additionally, LPA conducted interviews with Licensees and additional witnesses. Reports of alleged abuse were not elevated by medical professional who examined Child 1 or by Department of Children and Family Services who are currently involved with Child 1 and family. Interviews conducted did not corroborate allegation.
Based on the information and evidence obtained, Child 1 attended the facility from approximately November 2020 until early May 2021 but interviews conducted were unable to determine if Child 1 was inappropriately touched while in care.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

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 54-CC-20210720171018

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DIAZ, MARIA AND IBOA, JORAM FAMILY DAY CARE	FACILITY NUMBER: 191806680
	VISIT DATE: 09/02/2021

NARRATIVE

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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted with the Licensee-Maria Diaz. Copy of the appeal rights (LIC9058 01/16) were provided and explained. Upon receipt, Licensee posted the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

LIC9099 (FAS) - (06/04)

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