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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376619543
Report Date: 11/17/2021
Date Signed: 11/17/2021 10:03:57 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
11/05/2021 and conducted by Evaluator Nancy Diaz
COMPLAINT CONTROL NUMBER: 51-CC-20211105151847
FACILITY NAME:NEVAREZ, LOURDES & EDUARDO FAMILY CHILD CAREFACILITY NUMBER:
376619543
ADMINISTRATOR:LOURDES & EDUARDO N.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 562-0509
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:14CENSUS: 1DATE:
11/17/2021
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Lourdes & Eduardo Nevarez TIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not meet child's diapering needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/17/21 @ 9:40AM, Licensing Program Analyst arrived at the facility to deliver the findings to the above allegation. Mr. & Mrs. Nevarez were home today, providing care to 1 child.
Based on the information obtained during interviews with both licensees and the parent of the child in care and observation of the child in care, it is determined that the above-referenced allegations are 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.

An exit interview was conducted. Notice of Site Visit was given and will remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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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