393622570-5-4-2022-53-CC-JSMH-CE6QLZ-20220506121644

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393622570
Report Date: 04/21/2022
Date Signed: 05/04/2022 02:34:22 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/28/2021 and conducted by Evaluator Chayntel Hunter

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20210928102021

FACILITY NAME:	MARTIN, LAKISHA		FACILITY NUMBER:	393622570
ADMINISTRATOR:	MARTIN, LAKISHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 271-4228
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95212
CAPACITY:	14	CENSUS: 4	DATE:	04/21/2022
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Licensee, Lakisha Martin		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Conduct Inimical

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Chayntel Hunter and Lauren Scott met with Licensee, Lakisha Martin to deliver the findings of the complaint investigation regarding the above allegation. Investigator Jorge Martinez from the Department’s Investigation Branch (IB) conducted the complaint investigation in conjunction with the San Joaquin County Children Service Bureau and the Stockton Police Department. The complaint alleged that an adult in the home (A1) engaged in inappropriate interactions with a minor (C1) in the home. IB conducted interviews, which provided inconsistent information to support the allegation.

Based on the information obtained throughout the course of this investigation the above allegation could not be substantiated or dismissed. 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 finding is UNSUBSTANTIATED. Exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022

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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