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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 192006280
Report Date: 11/16/2021
Date Signed: 11/16/2021 09:29:33 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/26/2021 and conducted by Evaluator Bardo Baluyot
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20210726130712
FACILITY NAME:MARIONA FAMILY CHILD CAREFACILITY NUMBER:
192006280
ADMINISTRATOR:MARIONA, SUSANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 573-3927
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY:14CENSUS: 1DATE:
11/16/2021
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Licensee, Susana MarionaTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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On 11/16/2021 at 8:35 AM, Licensing Program Analyst (LPA) Bardo Baluyot, conducted an unannounced Complaint Inspection to conclude the investigation regarding the above complaint allegation. LPA conducted a COVID risk assessment prior to entering the facility. LPA met with Licensee, Susana Mariona. There was 1 child present. Per Licensee most of the children arrive for after school care.

During the course of the investigation conducted by Investigations Branch (IB) Investigator, Jose Santana, interviews were conducted, documents were obtained including facility photographs, the police report from the Los Angeles County Sheriff’s Department, facility roster, and other documentation. This agency has investigated the complaint alleging sexual abuse. Based on the evidence, this agency has determined the allegation is unsubstantiated. 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.
PG 1 of 2


Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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 2
Control Number 33-CC-20210726130712
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MARIONA FAMILY CHILD CARE
FACILITY NUMBER: 192006280
VISIT DATE: 11/16/2021
NARRATIVE
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Per California Code of Regulations Title 22, Division 12, no deficiency cited. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Susana Mariona.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2