198013729-3-11-2021-33-CC-CGUA-BZVQ4Z-20210408115111

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198013729
Report Date: 03/11/2021
Date Signed: 03/11/2021 04:08:12 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
08/27/2020 and conducted by Evaluator Fabiola Vasquez

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200827090507

FACILITY NAME:	JUAREZ FAMILY CHILD CARE		FACILITY NUMBER:	198013729
ADMINISTRATOR:	JUAREZ, JUANA & MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 356-4350
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	14	CENSUS: 1	DATE:	03/11/2021
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Maria Juarez		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Daycare child sustained unexplained injury while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility on 3/11/21 via telephone by Facetime due to COVID-19 and precautionary measures. LPA spoke with Maria Co-Licensee and Licensee, Juana Juarez. LPA identified herself and stated the purpose of the contact is to provide the findings for the above allegation. The call was transferred to facetime to complete the virtual tele-inspection tour of the facility. Census: 1 Staff: 2

Pertaining to the allegation that, Daycare child sustained injury while in care. During the investigation, interviews were conducted with the reporting party, four children, two parents and two staff. LPA obtained a copy of the children’s roster, and reviewed additional documents.

Based on the evidence obtained during the investigation through, interviews, observation, and review of records, there were no disclosures made that support the allegation. That Daycare child sustained injury while in care. There were collaborating statements made by C2, P1 and P2 that children feel and are safe while in care, other statements made are that children have not gotten hurt while in care.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2021

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-20200827090507

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: JUAREZ FAMILY CHILD CARE	FACILITY NUMBER: 198013729
	VISIT DATE: 03/11/2021

NARRATIVE

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Due to information and statements initially stated during interviews. The allegation has been determined to be Unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
Exit phone interview has been conducted with Co-Licensee Maria Juarez and Licensee Juana Juarez. Appeal Rights were verbally explained and provided to Licensee as well. A copy of this report (LIC 9099) along with the Appeal Rights LIC (9058) has been signed by LPA Vasquez. This report along with the Appeal Rights will be scanned via e-mail to the Licensee, 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, and the Appeal Rights will be mailed, and the Licensee agrees to sign the bottom of each page of the LIC 9099 and return the originals to LPA Vasquez in-person or via U.S. Mail. A Notice of Site Visit was not provided to Licensee since a physical inspection was not conducted.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola Vasquez	TELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2021

LIC9099 (FAS) - (06/04)

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