198400181-1-21-2021-54-CC-TCON-BZ35Z8-20210312192330

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198400181
Report Date: 01/21/2021
Date Signed: 01/21/2021 04:34:04 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 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
12/14/2020 and conducted by Evaluator Tiffanie Tran

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20201214115025

FACILITY NAME:	PATRICK FAMILY CHILD CARE		FACILITY NUMBER:	198400181
ADMINISTRATOR:	JENNIPHER PATRICK		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 354-8735
CITY:	COMPTON	STATE: CA	ZIP CODE:	90220
CAPACITY:	14	CENSUS: 4	DATE:	01/21/2021
		UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Jennipher Patrick, Licensee		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

1
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8
9

Personal Rights- Day care sustained injury while in care

INVESTIGATION FINDINGS:

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2
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13

Due to COVID-19 and precautionary measures, Licensing Program Analyst (LPA) T. Tran delivered this final finding of the above complaint allegation by use of via telephone with Licensee, Jennipher Patrick on 01/21/2021.
Based upon the evidence obtained during the course of the investigation through interviews and record reviewed, the evidence does not support, nor disprove the above allegation of C1 fell at daycare as result of vomiting occurred at the facility. None of the interviewed parties observed C1 fell and sustained a “knot” on the upper right side of the forehead. Therefore, the allegations have been determined unsubstantiated. Unsubstantiated – A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
An exit interview was conducted with the licensee. This report along with a notice of site visit, a copy of the appeal rights was via emailed to licensee. Via email with a read receipt or confirmation of receipt of email, which will act as the licensee's signature.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021

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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