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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393608028
Report Date: 04/09/2024
Date Signed: 04/09/2024 10:54:22 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2024 and conducted by Evaluator Carla Polanco Rivera
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240129142101
FACILITY NAME:BENAVIDES, IRMAFACILITY NUMBER:
393608028
ADMINISTRATOR:BENAVIDES, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 367-5573
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:14CENSUS: 2DATE:
04/09/2024
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Licensee Irma BenavidesTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
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9
Personal rights: Adult in the home yelled at daycare children.
INVESTIGATION FINDINGS:
1
2
3
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5
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8
9
10
11
12
13
On 4/9/24, Licensing Program Analysts (LPA) Carla Polanco met with Licensee, Irma Benavides, and conducted an unannounced visit to deliver the findings of a complaint investigation regarding the above allegation. There were 2 children present during the inspection. During the investigation, LPA made observations at the facility, obtained relevant documents and conducted interviews with the Reporting Party and another adult familiar with the complaint, the License, Licensee's assistant, daycare children and daycare parents pertaining to the allegations.

It was alleged that an adult in the home yells at daycare children. Observations and interviews conducted by LPA throughout the course of the investigation did not disclose any information that was evident to support the allegation. Based on the collected information, the findings are UNSUBSTANTIATED as there was not a preponderance of evidence to prove or negate the specific allegations.

An exit interview was conducted, and the report was reviewed with the Licensee. A notice of site visit was posted by LPA and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Carla Polanco RiveraTELEPHONE: (916) 212-0752
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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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