304312394-10-1-2019-06-CC-RLOZ-BGN27U-20191004170919

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304312394
Report Date: 10/01/2019
Date Signed: 10/01/2019 09:41:39 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
08/15/2019 and conducted by Evaluator Wendy Port

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20190815104953

FACILITY NAME:	HERNANDEZ-AREVALO ASCENCION E & AREVALO ROBERTO		FACILITY NUMBER:	304312394
ADMINISTRATOR:	AREVALO ESPERANZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 415-9125
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92805
CAPACITY:	14	CENSUS: 2	DATE:	10/01/2019
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Ascencion Esperanza Hernandez-Arevalo		TIME COMPLETED:	09:40 AM

ALLEGATION(S):

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Daycare provider lays down with daycare children
Daycare provideer is mean to daycare children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Port conducted an unannounced visit to the facility in response to a complaint received with above allegations. This is a continuation on the investigation intiated on 08/19/2019.

Upon arrival LPA observed 1 preschool age child and 1 infant being cared for by the licensee, Ascencion Esperanza Arevalo-Hernandez. Also present during today's inspection was co-licensee Roberto Arevalo in an off-limits area. During today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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(Continued on Page 2 - LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019

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 06-CC-20190815104953

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: HERNANDEZ-AREVALO ASCENCION E & AREVALO ROBERTO	FACILITY NUMBER: 304312394
	VISIT DATE: 10/01/2019

NARRATIVE

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During the investigation LPA interviewed 2 adults, the licensee, co-licensee, 2 staff members, and 3 children. LPA also reviewed children's records. Complainant stated a child disclosed they do not like day care and when asked why the child stated, "I don't like Roberto he is mean and takes kids to lay down with him". LPA conducted an interview with the subject child and there were no disclosures made to support the allegation. In the interviews conducted with other day care children children stated they like their day care and the licensee, co-licensee and staff members are nice. The licensee stated Roberto, co-licensee helps with the children on an as needed basis however primary care is provided by herself and 2 assistants. The licensee stated Roberto's primary job duty is to do school drop-off and pick up for school age children. The licensee stated children nap on individual mats (photographs were taken) and she is usually in the room to supervise children. The two assistants interviewed stated they are present when children nap and Roberto provides minimal assistance with the children. In an interview conducted with the co-licensee he denied the allegations.

Some children could not be interviewed due being non-verbal. Based on the information obtained from the interviews conducted there was a lack of evidence to corroborate the allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged personal rights violations did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted. Notice of Site Visit was posted during the visit. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019

LIC9099 (FAS) - (06/04)

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