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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313174
Report Date: 12/16/2019
Date Signed: 12/16/2019 11:09:59 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
11/13/2019 and conducted by Evaluator Dean Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20191113150428
FACILITY NAME:SMITH, TAMARAFACILITY NUMBER:
304313174
ADMINISTRATOR:SMITH, TAMARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 619-2365
CITY:IRVINESTATE: CAZIP CODE:
92602
CAPACITY:14CENSUS: 7DATE:
12/16/2019
UNANNOUNCEDTIME BEGAN:
10:31 AM
MET WITH:Tamara SmithTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff are not assisting daycare children with toileting.
Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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An inspection was made at the facility by Licensing Program Analyst (LPA) Dean Valencia to investigate the above allegations. LPA met with the licensee Tamara Smith, and licensee's spouse/assistant. During the course of the investigation, LPA interviewed the licensee and licensee's spouse/assistant, parents of children in care, and conducted two separate physical plant inspections. It has been determined that from all of the available information obtained by LPA during the course of the investigation, that there is insufficient evidence indicating that the allegations occurred, or that the facility violated ratio regulations nor the children's personal rights. From the investigation conducted, there is not a preponderance of evidence to support that the staff are not assisting children with toileting, or that the facility is operating out of ratio. These allegations could not be proven, but at the same time the LPA was unable to obtain any information showing that these allegations were definitively false, and proven to be unfounded. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. (continued on LIC9099C)`
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019
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-20191113150428
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: SMITH, TAMARA
FACILITY NUMBER: 304313174
VISIT DATE: 12/16/2019
NARRATIVE
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An exit interview was completed. The report and findings of the complaint were reviewed and discussed with the licensee and assistant, and was provided a copy of appeal rights (LIC 9058 12/15). Their signature on this form acknowledges receipt of these rights. Notice of Site Visit was posted during the visit, and must remain posted for 30 days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2