<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197700184
Report Date: 08/31/2021
Date Signed: 08/31/2021 01:30:02 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
06/10/2021 and conducted by Evaluator Lady King
COMPLAINT CONTROL NUMBER: 12-CC-20210610172632
FACILITY NAME:FONSECA, JAIME FAMILY CHILD CAREFACILITY NUMBER:
197700184
ADMINISTRATOR:FONSECA, JAIMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 675-8156
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:14CENSUS: 1DATE:
08/31/2021
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Jessica Cardenas TIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day-care staff caused injuries to child in care.
Day-care staff yells at day-care children.
Day-care staff hit child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 Licensing Program Analyst (LPA) Lady King-Lewis conducted a subsequent investigation inspection for the purpose of delivering the finding on the above allegation. Upon arrival, LPA was greeted by Licensee assistance Jessica Cardenas. Licensee's infant child present at the time of this inspection.

The investigation consisted of interviews with Licensee, Licensee’s assistances, children in care and other relevant complaint parties The investigation revealed the following:

Base on the interviews conducted there was inconsistent statements regarding child being injured at day care, day care staff yells at day care children and day care staff hit child in care.

Interviews disclosed when children do no follow direction or do something they are not supposed to do; day care staff do not yell or hit a child; day care staff will place child on time out or child may get suspended.
At this time the above allegations are deemed Unsubstantiated.
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: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021
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-20210610172632
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: FONSECA, JAIME FAMILY CHILD CARE
FACILITY NUMBER: 197700184
VISIT DATE: 08/31/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged allegations occurred. At this time LPA, unable to make determination that any violation occurred.

An exit interview was conducted, copy of this report, Appeal Rights and Notice of Site Visit was provided to licensee's assistance Jessica Cardenas.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2