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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343618560
Report Date: 04/22/2022
Date Signed: 04/22/2022 11:59:43 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2021 and conducted by Evaluator Fabiola Diaz
COMPLAINT CONTROL NUMBER: 03-CC-20211027133847
FACILITY NAME:IBARRA, OBDULIAFACILITY NUMBER:
343618560
ADMINISTRATOR:IBARRA, OBDULIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 821-5974
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:14CENSUS: 7DATE:
04/22/2022
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Obdulia IbarraTIME COMPLETED:
12:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child in care was inappropriately touched by another child.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Fabiola Diaz arrived at the facility at approximately 11:35 am and met with licensee Obdulia Ibarra to close a complaint investigation regarding the above allegation. Upon arrival LPA observed 7 children. Also present was licensee’s husband. It was alleged that a child (C1) inappropriately touched another child (C2). The investigation was conducted by Investigator Andrew Murrow. During the course of the investigation Investigator Andre Murrow interviewed individuals involved in the allegation. The information provided during the course of the investigation was conflicting and not substantial enough to prove or disprove the allegation. Based on investigator’s investigation 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. There were no Title 22 deficiencies during today’s investigation. Appeal Rights were provided to licensee. A notice of site visit was given and must remain posted for 30 days at the facility. Exit interview conducted and report was reviewed with the licensee, and a copy was provided to licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Fabiola DiazTELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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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