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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376614787
Report Date: 07/05/2022
Date Signed: 07/05/2022 02:04:01 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, 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
03/21/2022 and conducted by Evaluator Samantha Clenista
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20220321101745
FACILITY NAME:REJANE, MINNIE FAMILY CHILD CAREFACILITY NUMBER:
376614787
ADMINISTRATOR:MINNIE REJANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 219-7287
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:14CENSUS: 11DATE:
07/05/2022
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Daniela Carvalho & Maria Arrieta PenaTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child sustained unexplained injury.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 07/05/22 at 10:20am, Licensing Program Analyst (LPA) Samantha Clenista conducted an unannounced inspection to deliver complaint findings for the allegation listed above. Upon arrival, LPA met with Licensee's helpers, Daniela Carvalho & Maria Arrieta Pena. A full investigation was conducted by the Department’s Investigations Branch (IB) investigator. It was alleged a day-care child sustained an unexplained injury. During the course of the investigation, interviews were conducted with licensee, current and past facility staff. Medical records were also obtained and review. Based on information obtained from interviews and related documentation, there was not a preponderance of evidence to prove the alleged violation did or did not occur, there for the allegation is unsubstantiated. An exit interview was conducted with Ms. Carvalho along with Licensee (via telephone). Due to printer malfunctions, LPA will email a copy of this report, appeal rights, a Notice of Site Visit to Licensee, Ms. Rejane. Notice of Site Visit is to be posted and remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha ClenistaTELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2022
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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