198008409-4-7-2021-33-CC-CGUA-BZWV5K-20210409160803

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198008409
Report Date: 04/07/2021
Date Signed: 04/07/2021 02:50:30 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/04/2020 and conducted by Evaluator Betty Bell

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200304165151

FACILITY NAME:	DOBARD FAMILY CHILD CARE		FACILITY NUMBER:	198008409
ADMINISTRATOR:	DOBARD, SHERIDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 505-7889
CITY:	POMONA	STATE: CA	ZIP CODE:	91766
CAPACITY:	14	CENSUS: 8	DATE:	04/07/2021
		UNANNOUNCED	TIME BEGAN:	02:18 PM
MET WITH:	Licensee Sherida Dobard		TIME COMPLETED:	02:43 PM

ALLEGATION(S):

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Excluded individual living in the home

INVESTIGATION FINDINGS:

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An unannounced follow-up tele-inspection was conducted on this date by Licensing Program Analyst (LPA) Emiko Bell via FaceTime with Licensee Sherida Dobard due to COVID-19 and precautionary measures. The purpose of the tele-inspection, to deliver findings on a complaint, was stated to Licensee Dobard via FaceTime.

Census: There were two staff and eight children present.

-Pertaining to the allegation that there is an “Excluded individual living in the home”:

Throughout the course of the investigation, interviews were conducted with two staff and the LA County Probation Department and documentation in the form of photos were obtained. Interviews conducted and documentation obtained provided conflicting information as to where the excluded individual resides, and for how long they have been residing at the different residences.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2021

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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Control Number 33-CC-20200304165151

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: DOBARD FAMILY CHILD CARE	FACILITY NUMBER: 198008409
	VISIT DATE: 04/07/2021

NARRATIVE

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Although LPA Bell observed an individual matching the description of the excluded individual on March 6, 2020 while at the residence, and though Staff #2 stated that the Excluded individual was in their room and lives in the residence, the person left before their identity could be confirmed. Though licensee’s address is the record of address for the Excluded individual, verifiable information could not be obtained as to where the Excluded individual physically resided from January 20, 2020-March 16, 2020. The Department received information regarding the excluded individual’s current address as of March 17, 2020.

This agency has investigated the complaint alleging that there was a violation of Title 22, Division 12, Chapter 1, Article 3, Section 102370.1 "Criminal Record Exemptions." The complaint alleged that an individual on felony probation has been living at the residence despite not having a Criminal Record Exemption. Based upon the evidence as presented above, the allegation has been determined to be Unsubstantiated. A finding of Unsubstantiated means that 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.

No deficiencies are being cited for the allegation listed above.

An exit interview has been conducted with Licensee Dobard. A copy of this report has been signed by LPA Bell. This report will be scanned via e-mail to Licensee Dobard, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. A hard copy of this report will be mailed to Licensee Dobard, who agrees to sign the bottom of each page of the 9099 and return the originals to LPA Bell in-person or via U.S. Mail. A Notice of Site Visit was not provided to Licensee Dobard since a physical inspection was not conducted.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Betty Bell	TELEPHONE: (323) 981-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2021

LIC9099 (FAS) - (06/04)

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