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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376628204
Report Date: 07/26/2019
Date Signed: 07/26/2019 03:24:31 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
05/15/2019 and conducted by Evaluator Diana Sanchez
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20190515130331
FACILITY NAME:RODRIGUEZ, MAYRA FCCFACILITY NUMBER:
376628204
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
07/26/2019
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Mayra Rodriguez, ProviderTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Lack of supervision resulted in inappropriate play between day care child and minor in the home.
Minors in the home were smoking on the premises.
Uncleared adults are living in the home.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Diana Sanchez, made an unannounced complaint inspection today and met with Mayra Rodriguez to deliver complaint finding on the above allegations. Current census is 2.

This agency has investigated the complaint alleging Lack and supervision resulted in inappropriate play between daycare child and minor in the home, Minors in the home were smoking on the premises and uncleared adults living in the home.
During the investigation, LPA reviewed children’s records, interviewed facility staff, children and parents. Both Licensees deny the allegations; explaining that they are always supervising the children ensuring that they play safe and interact with each other in a respectful way. Provider stated that no one in the home smokes and the only adults living in the home are her, husband and children. Sometimes her sister stays over, but she is fingerprint cleared.

There is insufficient evidence to support and no witnesses to corroborate the above allegations. LPA was unable to determine whether or not the above allegations happened. Therefore, based on the information obtained the allegations are deemed unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019
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 20-CC-20190515130331
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: RODRIGUEZ, MAYRA FCC
FACILITY NUMBER: 376628204
VISIT DATE: 07/26/2019
NARRATIVE
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A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occurred.

An exit interview was conducted with Mayra Rodriguez and a copy of this report left at the facility. LPA observed provider placing the Notice of Cite Visit on the wall visible to parents during today’s inspection.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2