198018389-3-29-2021-54-CC-KCHS-C2AQ6J-20210421115338

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198018389
Report Date: 03/23/2021
Date Signed: 03/29/2021 08:05:29 AM

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
11/16/2020 and conducted by Evaluator Alicia Mooberry

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20201116151802

FACILITY NAME:	CONTRERAS FAMILY CHILD CARE		FACILITY NUMBER:	198018389
ADMINISTRATOR:	CONTRERAS, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 982-3522
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90059
CAPACITY:	14	CENSUS: 5	DATE:	03/23/2021
		UNANNOUNCED	TIME BEGAN:	04:39 PM
MET WITH:	Maria Lorena Contreras, Licensee		TIME COMPLETED:	06:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child bitten while in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced complaint inspection on 03/23/21 at 4:32 PM to deliver findings for the above allegations. Due to COVID-19 and precautionary measures this inspection was conducted via video conference using licenee's phone. This inspection was conducted in English. LPA met with Licensee, Maria Contreras, who guided LPA on tele-tour of the facility. There were 5 children present during the inspection.

During the course of this investigation, LPA interviewed Licensee, reporting parties, parents and children. Documentation was collected and reviewed.
Information provided by Reporting party indicates that a child was bitten while in care.

Licensee, Adult #1 and Adult #6 confirmed that there have been biting incidents at the daycare. However, based on information gathered the incidents were sporadic, required no medical attention and did not violation Title 22 regulations. ----Page 1 of 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2021

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 54-CC-20201116151802

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 198018389
	VISIT DATE: 03/23/2021

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

Children interviewed made no disclosures regarding the above allegation.

Based on interviews conducted the above allegation is found to be UNSUBSTANTIATED, although the allegation may have happened or valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted virtually by LPA with Maria Contreras, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

This report was sent via email to Licensee and an electronic read receipt confirms receiving the report. The Licensee was provided with the Monterey Park South West office address and agrees to send the signed originals by mail.

End of Report

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2