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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376619543
Report Date: 10/09/2019
Date Signed: 10/09/2019 01:21:49 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
08/27/2019 and conducted by Evaluator Nancy Diaz
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20190827182152
FACILITY NAME:NEVAREZ, LOURDES & EDUARDO FAMILY CHILD CAREFACILITY NUMBER:
376619543
ADMINISTRATOR:LOURDES & EDUARDO NEVAREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 562-0509
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:14CENSUS: DATE:
10/09/2019
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Lourdes NevarezTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Supervision - Day care child received multiple injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection to deliver the findings for the above allegations. LPA met with Eduardo and Lourdes Nevarez, Licensees. Observed present today was one child. The initial complaint inspection was conducted on 9/05/2019. During the course of the investigation, LPA conducted interviews with both licensees, children in care and and a day care parent. Based on the information gathered, it could not be conclusively determined whether the licensees failed to provide adequate supervision to a child who received multiple injuries while in care. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview was conducted with Lourdes & Eduardo Nevarez. The NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed Mrs. Nevarez post notice of site visit. LPA provided and reviewed a copy of appeal rights (LIC 9058) with Mr. & Mrs. Nevarez, her signature on this form acknowledges receipt of these rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
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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