343622373-3-19-2020-53-CC-MMAA-BPDQGY-20200507121017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343622373
Report Date: 03/19/2020
Date Signed: 03/19/2020 10:45:12 AM

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
02/21/2020 and conducted by Evaluator Amy Silva

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20200221082310

FACILITY NAME:	GODINEZ, JUANITA		FACILITY NUMBER:	343622373
ADMINISTRATOR:	GODINEZ, JUANITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 230-6190
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	14	CENSUS: 8	DATE:	03/19/2020
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Juanita Godinez		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Day care child sustained unexplained injury while in care
Provider did not inform day care child's parent of incident
Licensee is not present at the facility a sufficient amount of time

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Silva met with Licensee Juanita Godinez to deliver findings on a complaint investigation. It was alleged that a day care child sustained an unexplained injury while in care. Based on complainant’s statement, Licensee provided conflicting reasoning for the injury. Throughout the investigation, LPA conducted interviews with the complainant, four children, five parents and staff, reviewed documents, obtained the facility's roster and made observations of the operation of the facility. In addition, complainant provided LPA photos of the injury. LPA learned, although the child sustained an injury, there was no evidence to support the injury occurred at the facility.

It was also alleged that staff failed to notify parent of incidences involving her child. The Department received a report that a child sustained an unexplained injury on their head and scratches on their face.
Report continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2020

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 53-CC-20200221082310

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: GODINEZ, JUANITA	FACILITY NUMBER: 343622373
	VISIT DATE: 03/19/2020

NARRATIVE

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Throughout the investigation, LPA conducted interviews with the complainant, four children, five parents and staff, reviewed documents, obtained the facility's roster, and made observations of the facility. Per licensee, no injury occurred or was observed in the daycare. LPA was unable to determine where alleged injuries occurred. Based on interviews and observations, LPA determined the information obtained during the investigation revealed inconsistencies.

It was also alleged that the licensee is not present at the facility a sufficient amount of time. LPA conducted interviews with four children, five parents, staff and children. Based on the information collected through the interviews, parents stated they always observe the licensee at the facility, providing care during drop off and pick up times and licensee informs them of any changes ahead of time. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations did or did not occur, therefore these allegations are UNSUBSTANTIATED. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is found to be UNSUBSTANTIATED.

Exit interview conducted. No deficiencies cited. Appeal rights provided. Notice of site visit was issued and must remain posted for 30 days.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2020

LIC9099 (FAS) - (06/04)

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