197493287-4-4-2024-54-CC-DGIS-D5BKYW-20240516081947

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197493287
Report Date: 04/04/2024
Date Signed: 04/04/2024 12:27:07 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 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
03/21/2024 and conducted by Evaluator Katrina Chicote

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20240321163317

FACILITY NAME:	URIZAR FAMILY CHILD CARE		FACILITY NUMBER:	197493287
ADMINISTRATOR:	URIZAR, SANDRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 815-5336
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY:	14	CENSUS: 7	DATE:	04/04/2024
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Sandra Urizar, Licensee		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Personal Rights - Child sustained an injury while in care

INVESTIGATION FINDINGS:

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On 04/04/2024 at 11:15 AM Licensing Program Analysts (LPAs) Katrina Chicote and Claudia Kam conducted an Unannounced Complaint Inspection for the purpose of initiating 10-day inspection and delivering findings to the above allegation. LPAs observed six preschoolers and one infant with Licensee and Assistant, total census of seven children present at time of inspection. All adults present in the home have criminal record clearance at time of inspection.

During this inspection, LPAs conducted tour of outside play area where incident took place. LPAs observed the toys mentioned in report to be standard unit wooden blocks that are sanded and painted, confirming information provided by RP. LPA Kam conducted interviews with Licensee, Licensee confirms that child was hit by a block and child named in report also confirmed during inspection information provided on the report. Licensee called Licensing to report unusual incident on 03/20/2024 regarding incident reported by RP, providing additional confirmation that child sustained injury while in care. Personal Rights of children were observed on this date as well as active supervision being provided by Licensee and Assistant during today's inspection
Report Continues - Page 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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 54-CC-20240321163317

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: URIZAR FAMILY CHILD CARE	FACILITY NUMBER: 197493287
	VISIT DATE: 04/04/2024

NARRATIVE

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Based on the available information, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. A substantiated finding means that the complaint is valid because the preponderance of the evidence standard has been met.

Although the finding is substantiated, LPAs record review, observations, and interviews confirm that there was full supervision at the time of the incident, first aid was administered quickly, Authorized Representative was immediately informed of the injury, and Licensee reported the incident to The Department within the required time frame.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 04/04/2024.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Licensee, Sandra Urizar.

Report Ends - Page 2 of 2

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

LIC9099 (FAS) - (06/04)

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