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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197493650
Report Date: 09/10/2019
Date Signed: 09/10/2019 10:41:19 AM



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
08/20/2019 and conducted by Evaluator Cynthia Reyes
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20190820144419
FACILITY NAME:SALGADO FAMILY CHILD CAREFACILITY NUMBER:
197493650
ADMINISTRATOR:SALGADO, FLORENTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 774-7994
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:14CENSUS: 4DATE:
09/10/2019
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rosie CezaresTIME COMPLETED:
10:55 AM
ALLEGATION(S):
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Licensee failed to provide supervision resulting in children being injured.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Cynthia Reyes and Alicia Bailey, arrived unannounced at the facility for the purpose of conducting a follow up Inspection to present findings of the complaint allegation listed above. LPA met with Rosie Cezares, assistant who stated the licensee was out picking up children. Licensee arrived about an hour later with one child. Also in the home on this date are licensee two daughters America and Nancy who were both asleep in their bedrooms and licensee 11 year old son in his bedroom. Three children were in care with Rosie at time of arrival.

Based on LPA Interviews conducted and documents reviewed and received regarding, Licensee failed to provide supervision resulting in children being injured and although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Per interviews it was stated that the scratches on the children were from another child, when both children would fight over a toy or a spot on the couch. Licensee stated she had observe the incidents when the children would get scratches , but was unable to stop them on time when it happened.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
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-20190820144419
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: SALGADO FAMILY CHILD CARE
FACILITY NUMBER: 197493650
VISIT DATE: 09/10/2019
NARRATIVE
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Licensee stated she had informed the parents of the incidents of both children fighting on different occasions. It was also stated that the scratches were unknown were they came from. The incident with the child having a bead stuck in his nose was stated to be unknown how the bead got stuck, when it got stuck and where it happened when the bead was stuck in the nose. It was unknown if the child stuck the bead in his nose at home or at the day care or if another child stuck it in his nose, their were no witness of seeing the child with the beads, however older children in the day care were using beads to make bracelet's and no one witness the child near the beads and none gave the child any beads.

The notice of site visit was posted where the parent/guardian of children enter and exit the facility. This notice shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with the Licensee, during which appeal rights were explained. A copy of the appeal rights (LIC 9058 01/16) were provided. The Licensee signature on this report acknowledges receipt of her rights.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2