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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 192010484
Report Date: 04/28/2020
Date Signed: 04/28/2020 02:52:09 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 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
01/30/2020 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20200130114500
FACILITY NAME:AYALA FAMILY CHILD CAREFACILITY NUMBER:
192010484
ADMINISTRATOR:AYALA, DONIELLE FELINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 999-2508
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:14CENSUS: 3DATE:
04/28/2020
UNANNOUNCEDTIME BEGAN:
01:27 PM
MET WITH:Donielle AyalaTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Licensee inappropriately handled day care children
Licensee left child in urine soaked diaper for extended period of time
Licensee did not provide adequate supervision to children in care
INVESTIGATION FINDINGS:
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This complaint inspection was conducted by Licensing Program Analyst (LPA) Raul Navarro. Due to COVID-19 and precautionary measures, this inspection was conducted via FaceTime teleconference to deliver the findings of the complaint investigation. The teleconference was conducted with Licensee Donielle Ayala. There were three children present during the inspection.

During to the course of the investigation, LPA Navarro conducted interviews with the Complainant, Licensee, Parents, and child in care. Complaint alleges licensee handled children in a rough manner, left child in a urine soaked diaper, and did not provide adequate supervision to children in care. Interview was conducted with licensee who denied the allegations. Interviews were conducted with enrolled child, no disclosures were made. Interviews were conducted with parents of enrolled children, no disclosures were made. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore at this time the above allegations are Unsubstantiated.
*Report continues on the next page*
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2020
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 54-CC-20200130114500
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: AYALA FAMILY CHILD CARE
FACILITY NUMBER: 192010484
VISIT DATE: 04/28/2020
NARRATIVE
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Exit interview was conducted with Licensee Donielle Ayala, via teleconference, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt to confirm receipt of the report and appeal rights.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2