376628543-2-26-2021-20-CC-TVUU-BYM2L8-20210226162904

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376628543
Report Date: 02/26/2021
Date Signed: 02/26/2021 02:11:53 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
11/23/2020 and conducted by Evaluator Martha Malane

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20201123090110

FACILITY NAME:	MARTINEZ, MICHELLE FAMILY CHILD CARE		FACILITY NUMBER:	376628543
ADMINISTRATOR:	MICHELLE MARTINEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 862-1037
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	14	CENSUS: 4	DATE:	02/26/2021
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Michelle Martinez		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Licensee caused injury to a child

INVESTIGATION FINDINGS:

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On February 26, 2021, at 1:50pm, Licensing Program Analyst (LPA), Martha Malane conducted an unannounced video-conference via Zoom due to COVID-19 to deliver findings regarding the above complaint allegation and met with licensee, Michelle Martinez. LPA Malane notified licensee of the purpose of the inspection and was led on a tour of the facility. There were four (4) children in care at the time of the inspection.

On November 23, 2020, Community Care Licensing (CCL) received a complaint alleging the licensee caused injury to a child. The investigation was conducted by CCL Division Investigation Branch (IB). Throughout the course of the investigation, interviews were conducted with the reporting party, day care parents, the licensee and licensee’s assistant. Facility records, phone records and photos were reviewed.

See continuation on LIC9099C…

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha Malane	TELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

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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Control Number 20-CC-20201123090110

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: MARTINEZ, MICHELLE FAMILY CHILD CARE	FACILITY NUMBER: 376628543
	VISIT DATE: 02/26/2021

NARRATIVE

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Licensee stated the incident with Child #1 occurred on 11/20/2020 in the bathroom. She stated she was in the bathroom with another child when Child #1 (C1) ran inside and slipped on the stepping stool. She immediately attempted to catch C1; however, it happened so fast C1 already hit their left face/eye area on the sink then hit the toilet paper holder as they were falling. She was able to grab the child around their tummy/side with one hand and the other hand over/around the neck/shoulder area before hitting the floor. Licensee explained she has long fingernails, and her fingernails may have caused the scratches on the neck/back. Licensee stated she called the child’s parent after the event. Licensee stated she communicated with the child’s parent via phone calls, text messages and in person regarding the incident. She also documented the incident on an “Ouch Report” which was given to the child’s parent during pick up. Licensee denied abusing C1 on this date and/or while they were in her care.

Based on interviews and records review, 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 occur, therefore the allegation is found to be UNSUBSTANTIATED.

An exit interview was conducted and LPA discussed and will email the following documents to licensee: LIC9099, LIC9099C and appeal rights (LIC 9058). Licensee was advised that acknowledgement of receipt of the report and appeal rights are to be received within twenty-four hours.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha Malane	TELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

LIC9099 (FAS) - (06/04)

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