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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197417109
Report Date: 02/03/2020
Date Signed: 02/03/2020 02:31:16 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/01/2019 and conducted by Evaluator Lady King
COMPLAINT CONTROL NUMBER: 12-CC-20191101142027
FACILITY NAME:MARTINEZ FAMILY CHILD CAREFACILITY NUMBER:
197417109
ADMINISTRATOR:MARTINEZ/GUMERCINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 533-9317
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:14CENSUS: 1DATE:
02/03/2020
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Gumercinda MartinezTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Personal Rights: Adult in home had inappropriately contact with child.
Personal Rights: Daycare child was spanked while in care
Personal Rights: Licensee failed to address daycare child's diapering needs
INVESTIGATION FINDINGS:
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On February 03, 2020, Licensing Program Analyst (LPA) King and Ayala conduct a subsequent complaint inspection for the purpose of concluding the investigation concerning the above allegations. Upon arrival, LPA was greeted by Licensee Gumercinda Martínez . LPA observed 1 child in care and 1 staff providing care.
The investigation was conducted by investigator Douglas Real. The investigation consisted of interviews with staff, children in care and other relevant complaint parties. The statements obtained during the interviews conducted do not corroborate with the allegations. There were no witnesses that observed the adult inappropriate contact with the child or reported any inappropriate conduct against them. None of the children interviewed disclosed being spanked by the adult in the home or anyone else or seen any other children in the home spanked by anyone.
LPA King-Lewis interviewed parents of children in care concerning the allegation of facility did not meet the child’s diapering needs. The interviews revealed parents did not have any concerns or complains concerning their children’s diapering changes. Licensee stated whenever she has children in diapers, she changes the children’s diapers as needed. Parents bring their children’s diapers and licensee stated that she has additional diapers in case the child runs out of diapers.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
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 12-CC-20191101142027
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARTINEZ FAMILY CHILD CARE
FACILITY NUMBER: 197417109
VISIT DATE: 02/03/2020
NARRATIVE
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After review of the evidence obtained, there is conflicting information and based on the preponderance of evidence, the above allegations have been deemed to be unsubstantiated.

Exit interview was conducted, appeal rights and a copy of this report was read and given to Licensee.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2