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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376600079
Report Date: 01/29/2020
Date Signed: 01/29/2020 03:49:13 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2019 and conducted by Evaluator Luigi Gargaro
COMPLAINT CONTROL NUMBER: 20-CC-20191105122520
FACILITY NAME:NHA - JOHN MARSHALL HEAD STARTFACILITY NUMBER:
376600079
ADMINISTRATOR:SCHROEDER, DOROTHEAFACILITY TYPE:
850
ADDRESS:3550 ALTADENA AVENUETELEPHONE:
(619) 624-2362
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:60CENSUS: DATE:
01/29/2020
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Site Supervisor Dorothea SchroederTIME COMPLETED:
03:50 PM
ALLEGATION(S):
1
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9
Daycare child received multiple unexplained injuries at facility.
INVESTIGATION FINDINGS:
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2
3
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5
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11
12
13
LPA, Luigi Gargaro, conducted an unannounced visit to the facility today to deliver the finding for the above listed allegation. During the course of the investigation, analyst conducted interviews with the facility director, staff, parents and children in care and reviewed documentation related to the child in question's reported injuries.

Based on the information gathered, analyst could neither prove nor disprove whether the injuries alleged occurred at the facility or what caused them. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
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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