343621704-11-8-2022-03-CC-RSAA-CLXQF7-20221209110729

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343621704
Report Date: 11/08/2022
Date Signed: 11/08/2022 01:11:03 PM

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
10/20/2022 and conducted by Evaluator Fabiola Diaz

COMPLAINT CONTROL NUMBER: 03-CC-20221020124129

FACILITY NAME:	ALVAREZ, JESSICA		FACILITY NUMBER:	343621704
ADMINISTRATOR:	ALVAREZ, JESSICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 671-9104
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY:	14	CENSUS: 10	DATE:	11/08/2022
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Jessica Alvarez		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Infant was left in soiled diaper for an extended period of time.
Staff did not provide proper food service to infant in care.
Infant sustained multiple unexplained injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Fabiola Diaz and Corina Beckby arrived at the facility at approximately 12:35 PM and met with licensee Jessica Alvarez to close a complaint investigation, regarding the above allegations. Upon arrival, LPAs observed 10 day care children and licensee’s staff. During the investigation LPA Diaz made observations, conducted interviews, and gathered documents pertaining to the investigation. It was alleged that there was one occasion when the infant was left in a soiled diaper for a long period of time. Licensee explained the infant was never left in a soiled diaper and infant was changed each time before leaving the facility. It was alleged infant was not fed baby food packed by infant’s parent. Licensee explained infant was initially fed from licensee’s own food (the same brand of baby food that parent packed) as agreed by licensee and parent. Licensee stated she works directly with a food program.

report continues on LIC9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

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 03-CC-20221020124129

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: ALVAREZ, JESSICA	FACILITY NUMBER: 343621704
	VISIT DATE: 11/08/2022

NARRATIVE

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It was also alleged that infant sustained unexplained scratches while in care. Infant did not receive medical treatment for the scratches. Licensee explained that she observed how the infant received two different scratches, and it was accidental. During facility inspections, LPA Diaz observed licensee adequately supervising the younger children and licensee’s staff adequately supervising the older children. Other parent interviews did not disclose concerns about diapering, food service, or unexplained injuries. 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.

An Exit Interview was conducted in which the report was reviewed and discussed with Licensee. A copy of this report was provided to the Licensee. A Notice of Site Visit and Appeal Rights were provided.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

LIC9099 (FAS) - (06/04)

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