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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198016060
Report Date: 12/08/2020
Date Signed: 12/08/2020 01:00:59 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
07/20/2020 and conducted by Evaluator Fabiola Vasquez
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20200720081830
FACILITY NAME:MENDOZA FAMILY CHILD CAREFACILITY NUMBER:
198016060
ADMINISTRATOR:MENDOZA, GLADYSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 498-3665
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:14CENSUS: 7DATE:
12/08/2020
UNANNOUNCEDTIME BEGAN:
12:08 PM
MET WITH:Gladys Mendoza, LicenseeTIME COMPLETED:
12:35 PM
ALLEGATION(S):
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Licensee served day care child spoiled milk.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility on 12/08/20 via telephone by Facetime due to COVID-19 and precautionary measures. LPA spoke with Gladys Mendoza, Licensee. LPA identified herself and stated the purpose of the contact is to provide the findings for the above allegation. Licensee provided a tour of the facility. Census: 7 Staff:2

Pertaining to the allegation that, Licensee served day care child spoiled milk. Due to information and contradictory 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.

*REPORT CONTINUES ON NEXT PAGE*
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola VasquezTELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2020
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 33-CC-20200720081830
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: MENDOZA FAMILY CHILD CARE
FACILITY NUMBER: 198016060
VISIT DATE: 12/08/2020
NARRATIVE
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An exit phone interview has been conducted with Licensee Gladys Mendoza. Appeal Rights were verbally explained to Licensee as well. A copy of this report 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.


*REPORT ENDS HERE*
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola VasquezTELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2