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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364843616
Report Date: 01/24/2023
Date Signed: 01/24/2023 11:22:23 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/19/2022 and conducted by Evaluator Carol Heath
COMPLAINT CONTROL NUMBER: 12-CC-20221019173145
FACILITY NAME:RIVAS FAMILY CHILD CAREFACILITY NUMBER:
364843616
ADMINISTRATOR:DELORES RIVASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 328-8477
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:14CENSUS: 0DATE:
01/24/2023
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Delores RivasTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
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Conduct Inimica
INVESTIGATION FINDINGS:
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On 1/24/2023, Licensing Program Analyst Carol Heath conducted an unannounced follow-up complaint investigation at the Rivas Family Child Care and met with Licensee Delores Rivas. The purpose of the visit is to deliver the complaint finding for the above allegation.
During the course of the investigation of this complaint, LPA Heath conducted interviews with the licensee and other related parties. Based on interviews and other evidence, it was determined that the licensee received money from Child Care Resource Center (CCRC) for child care service services that she4 did not provide.
Based on the information obtained, there is a preponderance of evidence to provide that the licensee failed to meet the Title 22 Regulation. Therefore, the above allegation is Substantiated
Type A deficiency was cited.

An exit interview was conducted, and a copy of the report was left with the licensee Delores Rivas.





























Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
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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