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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198006711
Report Date: 06/24/2021
Date Signed: 06/29/2021 03:56:57 PM



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
04/27/2021 and conducted by Evaluator Warren Birks
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20210427113308
FACILITY NAME:HENRIQUEZ FAMILY DAY CAREFACILITY NUMBER:
198006711
ADMINISTRATOR:HENRIQUEZ,LILIANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 594-8651
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY:14CENSUS: 13DATE:
06/24/2021
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Lillian HenriquezTIME COMPLETED:
01:55 PM
ALLEGATION(S):
1
2
3
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5
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7
8
9
 Provider yelled at authorized representative in the presence of children.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Warren Birks conducted an unannounced complaint inspection to deliver a finding for the above allegation. LPA met with Licensee Lillian Henriquez and cleared assistant who provided Spanish translation.

During the investigaton, LPA conducted child interviews and staff interviews. There were no disclosures that would corroborate the allegations. In addition, individuals alleged to witness the allegations first hand were unavailable to LPA. There was no other information that would substantiate the allegations. Although the above 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 at this time the above allegations are Unsubstantiated.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Appeal rights explained and given to Licensee Henriquez during exit interview.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
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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