334844254-10-19-2022-10-CC-SHUK-CKMV5Q-20221028160819

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334844254
Report Date: 10/19/2022
Date Signed: 10/19/2022 03:42:00 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/20/2022 and conducted by Evaluator Jeanette Sanchez

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20220720133755

FACILITY NAME:	RODRIGUEZ DE ESTRADA FAMILY CHILD CARE		FACILITY NUMBER:	334844254
ADMINISTRATOR:	CRUZ RODRIGUEZ DE ESTRADA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 619-0619
CITY:	INDIO	STATE: CA	ZIP CODE:	92201
CAPACITY:	14	CENSUS: 7	DATE:	10/19/2022
		UNANNOUNCED	TIME BEGAN:	03:02 PM
MET WITH:	Cruz Rodriguez de Estrada		TIME COMPLETED:	03:57 PM

ALLEGATION(S):

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Licensee did not adequately supervise a dog in the home that injured a child in care

INVESTIGATION FINDINGS:

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On 10/19/2022 at 3:06 PM, Licensing Program Analyst (LPA) Jeanette Sanchez arrived at the facility to provide findings to the complaint investigation. LPA met with licensee Cruz Rodriguez de Estrada.

On 7/20/2022, the department received a complaint alleging that the licensee did not adequately supervise a dog in the home that injured a child in care. The investigation consisted of interviews. LPA Sanchez attempted to obtain additional information from child and parent directly involved. However, due to parent not returning LPA's phone call, LPA was unable to obtain photo evidence or additional first hand account.

LPA's interview with licensee revealed that licensee was aware of an injury caused to a child by the dog in the home. The licensee stated that the injury required first aid in the

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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 10-CC-20220720133755

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: RODRIGUEZ DE ESTRADA FAMILY CHILD CARE	FACILITY NUMBER: 334844254
	VISIT DATE: 10/19/2022

NARRATIVE

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of a bandaid.

Based on LPA interview conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

See LIC9099D for deficiency.

An exit interview was conducted, and this report was reviewed with licensee Cruz Rodriguez de Estrada. Appeal rights were discussed and provided during the exit interview.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20220720133755

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: RODRIGUEZ DE ESTRADA FAMILY CHILD CARE	FACILITY NUMBER: 334844254
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/19/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/28/2022 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	(a) Each child...shall have certain rights that shall not be waived...These rights include, but are not limited to, the following:(2) To receive safe...accommodations...This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee will submit a written statement to LPA by 10/28/22, acknowledging that no dogs in the home will be allowed to be around or near the children in care.
	8 9 10 11 12 13 14	A child in care was injured by a dog in the home due to inadequate supervision. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Jeanette Sanchez	TELEPHONE: (951) 255-4577
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

LIC9099 (FAS) - (06/04)

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