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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197411347
Report Date: 01/03/2020
Date Signed: 01/03/2020 09:10:27 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/07/2019 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20191107131721
FACILITY NAME:SOSA FAMILY CHILD CAREFACILITY NUMBER:
197411347
ADMINISTRATOR:SOSA, YESENIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 367-2339
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:14CENSUS: 5DATE:
01/03/2020
UNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Yesenia SosaTIME COMPLETED:
09:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained unexplained injury while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On January 3, 2020 at 8:20 AM, Licensing Program Analyst (LPA) Loyce Phillips met with Licensee, Yesenia Sosa. LPA arrived to the facility to conduct a subsequent complaint investigation and deliver the findings pertaining to the allegation mentioned above.

Upon arrival, LPA observed 5 children in care, Licensee and licensee's assistant. During the course of this investigation, LPA conducted document review, interviews with staff members, parents and reviewed all information pertaining to the allegation mentioned above. Although the 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 the aforementioned allegations are unsubstantiated.

An exit interview was conducted and a copy of this report, notice of site visit, and appeal rights were provided to Licensee, Yesenia Sosa.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (661) 305-5243
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2020
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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