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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004621
Report Date: 07/07/2022
Date Signed: 07/07/2022 12:41:19 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/01/2022 and conducted by Evaluator Leslit Tapia-Mandujano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20220701162841
FACILITY NAME:SORTO, ANGELICAFACILITY NUMBER:
414004621
ADMINISTRATOR:SORTO, ANGELICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 384-6573
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:14CENSUS: 6DATE:
07/07/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee, Angelica SortoTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee administered another child's medication to a child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 7, 2022 at approximately 9:30am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced 10- day complaint inspection in response to the above allegations. LPA met with licensee, Angelica Sorto, and explained the purpose of the visit. Present during inspection included licensee and licensee's assistant caring for 6 children (1 infant, 3 preschoolers, and 2 school age).

During the investigation complaint that was received by department on 6/20/22, LPA substantiated the above allegation and deficiency was cited on 6/27/22. During that investigation, it was determined that with verbal consent of parent, cough syrup was administered to C2. Refer to 9099 and 9099D dated 6/27/22 for more details.

Exit interview conducted and report was reviewed with the licensee, Angelica Sorto.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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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