198020517-12-5-2024-33-CC-BVON-DDBBNJ-20250127001337

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198020517
Report Date: 12/05/2024
Date Signed: 12/05/2024 01:45:02 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 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
11/05/2024 and conducted by Evaluator Roxana Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20241105113324

FACILITY NAME:	FLORES FAMILY CHILD CARE		FACILITY NUMBER:	198020517
ADMINISTRATOR:	CYNTHIA G. FLORES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 433-7862
CITY:	SOUTH EL MONTE	STATE: CA	ZIP CODE:	91733
CAPACITY:	14	CENSUS: 7	DATE:	12/05/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Licensee Cynthia Flores		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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assdLicensee fed infant formula without the permission of the child's authorized representative

INVESTIGATION FINDINGS:

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An unannounced inspection was conducted by Licensing Program Analyst (LPA) Roxana Lopez on 12/5/2024. The purpose of this inspection is to provide the findings of the complaint investigation which was received on 11/05/2024. LPA met with Licensee, Cynthia Flores to whom the purpose of the inspection was announced. Census was taken.

Throughout the course of the investigation, interviews were conducted with staff, and parents. LPA also reviewed and obtained copy of children’s roster.

Per initial complaint report, the Reporting Party (RP) reported that Licensee fed Child # 1 infant formula with no authorization. Per RP child # 1 is only breastfeed- and child’s bottle had a residue that looked like formula, or like if something was mixed with breastmilk in the bottle.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024

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-20241105113324

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198020517
	VISIT DATE: 12/05/2024

NARRATIVE

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LPA conducted interviews with Staff # 1 and Staff # 2, staff corroborated that Licensee is the one that defrost breast milk from a baggy and transfers it into the bottle every time it is time for a feeding and is the only adult that feeds the infants. Licensee, states that they did not mixed formula or anything in a bottle.

LPA conducted interviews with parents. Parent’s statements corroborate that they do not have any concerns with what their children are being fed and that they are happy with the care their child receives.

This agency has investigated the complaint alleging Licensee fed infant formula without the permission of the child's authorized representative. 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 alleged violation(s) did or did not occur, therefore at this time the above allegation is unsubstantiated.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee Cynthia Flores.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024

LIC9099 (FAS) - (06/04)

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