192009786-5-11-2021-33-CC-CGUA-C2ZVV5-20210514164546

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 192009786
Report Date: 05/11/2021
Date Signed: 05/11/2021 04:06:23 PM

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
12/30/2020 and conducted by Evaluator Fabiola Vasquez

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20201230112901

FACILITY NAME:	ROBLES FAMILY CHILD CARE		FACILITY NUMBER:	192009786
ADMINISTRATOR:	ROBLES, DEANNA CORONADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 643-6254
CITY:	BALDWIN PARK	STATE: CA	ZIP CODE:	91706
CAPACITY:	14	CENSUS: 1	DATE:	05/11/2021
		UNANNOUNCED	TIME BEGAN:	03:47 PM
MET WITH:	Deanna Robles, Licensee		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Provider left children unattended.
Provider did not feed day care child.
Provider left day care child in soiled diaper.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility on 05/11/21 via telephone due to COVID-19 and precautionary measures. LPA spoke with Deanna Robles, Licensee. LPA identified herself and stated the purpose of the contact is to provide the findings for the above allegations. The call was transferred to facetime to complete the virtual tele-inspection tour of the facility. Census: 1 Staff: 2
The complaint was pertaining to the following allegations that, “Provider left children unattended”, “Provider did not feed day care child”, “Provider left day care child in soiled diaper”.
During the investigation, LPA Vasquez conducted an interview with RP, C1, and licensee. LPA attempted to conduct additional interviews with children, staff, and parents. LPA attempted to obtain a copy of the children’s roster including all the names of the children that attended within the last 3 years. On 12/29/20, LPA attempted to complete an interview with Licensee, during the 10-day tele visit inspection. LPA requested her children’s roster. On 01/04/21 and 01/05/21, LPA left licensee a phone message requesting licensee to call LPA.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021

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 33-CC-20201230112901

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: ROBLES FAMILY CHILD CARE	FACILITY NUMBER: 192009786
	VISIT DATE: 05/11/2021

NARRATIVE

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On 01/05/21, LPA emailed licensee to inform her that LPA left a voice message on 01/04/21 and 01/05/21. On 04/09/21, LPAs Vasquez and Mora attempted to conduct an on-site inspection at the facility. LPA Vasquez called the licensee while standing outside the facility. A voice message was left informing licensee of LPAs presence at the facility. LPA Mora also called attempting to speak with the licensee while standing outside the facility. LPA Mora left a message. On 04/09/21, LPA Vasquez attempted to contact licensee after the inspection was attempted. LPA Vasquez left a voice message and sent an email to licensee. On 04/14/21, LPA called Licensee asking for a return call before the end of the day. On 04/14/21, LPA emailed licensee at 1:34 PM to follow up. Licensee returned the call at 4:58 PM. LPA requested for a current children roster. On 04/14/21, LPA received via email at 5:04 PM a children’s roster.
On 04/15/21 at 9:52 AM LPA emailed licensee asking her to include all children in the roster, that she has had in care. Including children that went for one day. Licensee responded via email at 1:27 PM licensee stated on this day 04/15/21 “Hello you requested per our conversation the current roster and that is what I sent you." LPA attempted to contact parents from the roster provided. The contact numbers were not legible, and some phone numbers were disconnected. Emergency contact numbers should be current and readily available. On 04/15/21 at 1:49 PM licensee emailed and stated “Are you now requesting my roster from December 2020 that I have already emailed you previously. “ On 04/15/21 at 2:08 PM, Licensing Program Manager (LPM) Guangorena emailed licensee to clarify licensee’s question regarding children’s roster. On 4/26/21 at 11:22 AM LPM sent a follow-up email due to no response from licensee from the email sent on 04/15/21. LPM provided clarification that children’s roster is being requested for children licensee has had in her care within the last 3 years even if children were enrolled for a day. Until present day licensee has not contacted the department or submitted requested documents.
Due to licensee’s limited response to department staff and licensee not submitting required information/documents requested to department staff, the allegations have been determined to be UNSUBSTANTIATED. A finding of Unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are unsubstantiated.
Exit phone interview has been conducted with Licensee Deanna Robles. Appeal Rights were verbally explained and provided to Licensee as well. A copy of this report (LIC 9099) along with the Appeal Rights LIC (9058) has been signed by LPA Vasquez.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20201230112901

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: ROBLES FAMILY CHILD CARE	FACILITY NUMBER: 192009786
	VISIT DATE: 05/11/2021

NARRATIVE

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This report along with the Appeal Rights will be scanned via e-mail to the Licensee, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report, and the Appeal Rights will be mailed, and the Licensee agrees to sign the bottom of each page of the LIC 9099 and return the originals to LPA Vasquez in-person or via U.S. Mail. A Notice of Site Visit was not provided to Licensee since a physical inspection was not conducted.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021

LIC9099 (FAS) - (06/04)

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