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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304312129
Report Date: 06/14/2019
Date Signed: 07/23/2019 08:29:01 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2019 and conducted by Evaluator Thuy Ho
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20190429113423
FACILITY NAME:RIOS, HILARIAFACILITY NUMBER:
304312129
ADMINISTRATOR:RIOS, HILARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 530-2512
CITY:GARDEN GROVESTATE: CAZIP CODE:
92844
CAPACITY:14CENSUS: 7DATE:
06/14/2019
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Licensee Hilaria RiosTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Daycare child sustained unexplained injuries while in care
INVESTIGATION FINDINGS:
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A subsequent complaint inspection conducted on this day by Licensing Program Analyst (LPA) Ho. Census was taken: 3 infants, 1 preschool, and 3 school-age children with 2 staff members. LPA reviewed the care and supervision of children, and staffing ratios. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Through the course of investigation including interviewing children and parents, there was no disclosure of any child sustained any unexplained injury. Interviewed children stated they like going to this day care because licensee and the assistant are very nice. They also stated staff members supervise the children all the times. Licensee and assistant did not even use time out to discipline the children when the children were not behaving. Interviewed parents stated they love and trust licensee. Licensee and assistant are very nice to the children. The children are always supevised by licensee or assistant. Their children never come home with an explained injury. Licensee always communicates with the parents when anything happened to their children.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy HoTELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
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 06-CC-20190429113423
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: RIOS, HILARIA
FACILITY NUMBER: 304312129
VISIT DATE: 06/14/2019
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Exit interview was conducted. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. “The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.”
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy HoTELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2