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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376618494
Report Date: 12/12/2019
Date Signed: 12/12/2019 10:17:19 AM



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
09/17/2019 and conducted by Evaluator JoAnn R Legaspi
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20190917100038
FACILITY NAME:LEWIS, DESARAE FAMILY CHILD CAREFACILITY NUMBER:
376618494
ADMINISTRATOR:DESARAE LEWISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 992-4354
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:14CENSUS: 8DATE:
12/12/2019
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Desarare LewisTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Infant received unexplained bruising while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a complaint inspection regarding the above allegation. LPA advised Licensee Desarae Lewis of the purpose of the inspection and granted LPA facility entry. Present in the home was the Licensee, one (1) helper and eight (8) children.

The investigation involved reviews of facility, licensing and medical records. It also involved interviews of the Licensee and the helper. The investigation additionally included observations of the infant in issue, nonverbal children, interviews of their legal representatives/parents and outside source parties.

It was alleged an infant received bruising while in care. This child was physically handled by at least eight (8) different individuals; seven (7) are unrelated to the daycare. All the involved individuals report not observing the injury or awareness of its cause. The medical experts are unable to age the bruise. The infant is unable to provide a statement. Due to conflicting information and evidence, the allegation has been determined to be

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 51-CC-20190917100038
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LEWIS, DESARAE FAMILY CHILD CARE
FACILITY NUMBER: 376618494
VISIT DATE: 12/12/2019
NARRATIVE
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Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

A Notice of Site Visit (LIC 9213) was provided to the Licensee. This notice is to be posted for thirty (30) days. An exit interview was conducted with Licensee Desarae Lewis. Appeal Rights (LIC 9098 01/16) along with a copy of this report was provided to Licensee Desarae Lewis and their signature on this form confirms receipt of these rights.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2