233007641-9-17-2021-01-CC-AHON-C73PYC-20210921114341

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 233007641
Report Date: 09/17/2021
Date Signed: 09/17/2021 05:04:43 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/21/2021 and conducted by Evaluator Leticia Rosales

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20210621115133

FACILITY NAME:	CEJA DE LOPEZ, MARTHA FCCH		FACILITY NUMBER:	233007641
ADMINISTRATOR:	CEJA DE LOPEZ , MARTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 462-9658
CITY:	UKIAH	STATE: CA	ZIP CODE:	95482
CAPACITY:	14	CENSUS: 7	DATE:	09/17/2021
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Martha Ceja De Lopez		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Person in home hit child in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Leticia Rosales-Meza conducted an unannounced subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with the Licensee, Martha Ceja De Lopez. It has been alleged that a person in the home hit child in care, specifically that a staff slapped a child.

During the initial complaint investigation to the facility on 07/01/21, records were reviewed and the LPA conducted an interview with the Licensee at 2:45 PM. The Licensee denied the allegation and stated that she did not see anything, but knows very well it’s not true. Nothing has ever happened like that before of a staff person hitting a day care child, never. Licensee stated all the children are treated with dignity and respect,

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Leticia Rosales	TELEPHONE: (707) 588-5061
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021

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 01-CC-20210621115133

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: CEJA DE LOPEZ, MARTHA FCCH	FACILITY NUMBER: 233007641
	VISIT DATE: 09/17/2021

NARRATIVE

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An interview was conducted with Staff 1 (S1) on 7/01/21 at 4:00 PM. Interviews were conducted with Parent 1 (P1), and Child 2 (C2) on 09/16/21 starting at 5:53 PM. Interviews were conducted with Child 3 (3), Child 4 (4) and Adult 1 (A1) on 09/17/21 beginning at 1:51 PM.

The children interviewed during the investigation all stated that they felt safe while attending the family child care home.

During the tele-inspections, the LPA observed Licensee and S1 attending to all the children in the play room and backyard giving the children a lot of their attention.

Based on interviews conducted and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is Unsubstantiated.

There were no Title 22 deficiencies cited during today's inspection. All licensing reports are public information and must be made available upon request for at least three years. This report was reviewed and discussed with Licensee. Appeal Rights were provided.

Notice of Site Visit shall be posted for 30 days from today's visit

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Leticia Rosales	TELEPHONE: (707) 588-5061
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021

LIC9099 (FAS) - (06/04)

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