543909572-5-18-2020-04-CC-DLEN-BJ5W2V-20191121155458

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 543909572
Report Date: 10/29/2019
Date Signed: 05/18/2020 09:24:00 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/03/2019 and conducted by Evaluator Jessika Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20190903165950

FACILITY NAME:	GONZALEZ, STEPHANIE FAMILY CHILD CARE		FACILITY NUMBER:	543909572
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	10/29/2019
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Stephanie Gonzalez - Licensee		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Licensee allowed an unclear adult to reside in the home.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessika Thompson arrived at the facility to conduct an unannounced complaint inspection. The purpose of this inspection was to gather information to regarding the above allegation. LPA met with Licensee Stephanie Gonzalez who accompanied LPA during a tour of the facility. A census was taken and LPA explained the allegation to the licensee.

During the course of this investigation, LPA inspected pertinent areas of the family child care home, interviewed the licensee, and interviewed parents of children in care.

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 UNSUBSTANTIATED.

*This is an amended report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2020

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 8

Control Number 04-CC-20190903165950

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GONZALEZ, STEPHANIE FAMILY CHILD CARE	FACILITY NUMBER: 543909572
	VISIT DATE: 10/29/2019

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	This an amended report. This deficiency has been rescinded.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 8

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/03/2019 and conducted by Evaluator Jessika Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20190903165950

FACILITY NAME:	GONZALEZ, STEPHANIE FAMILY CHILD CARE		FACILITY NUMBER:	543909572
ADMINISTRATOR:	GONZALEZ, STEPHANIE		FACILITY TYPE:	810
ADDRESS:	3423 W PEREZ AVE		TELEPHONE:	(559) 393-6930
CITY:	VISALIA	STATE: CA	ZIP CODE:	93291
CAPACITY:	8	CENSUS: 6	DATE:	10/29/2019
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Stephanie Gonzalez		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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9

Infant sustained injuries while in care.
Licensee failed to ensure infant had an adequate amount of bottle feedings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessika Thompson arrived at the facility to conduct an unannounced complaint inspection. Information was gathered to investigate the above allegations. LPA met with Licensee, Stephanie Gonzalez, who accompanied LPA during a tour of the facility. LPA explained the reason for this inspection with the licensee and a census was taken.

During the course of this investigation, LPA reviewed records, observed children in care, and interviewed the licensee, and parents of children in care. LPA was unable to obtain information corroborating an infant sustained injuries while in care. Parents interviewed stated they were satisfied with the level of care their children received while in the care of the license. In addition, the licensee indicated there has not been any injuries sustained by any children while in her care.

(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 6 of 8

Control Number 04-CC-20190903165950

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GONZALEZ, STEPHANIE FAMILY CHILD CARE	FACILITY NUMBER: 543909572
	VISIT DATE: 10/29/2019

NARRATIVE

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Regarding the licensee failing to ensure infants have adequate bottle feedings, parents interviewed stated they were satisfied with the level of care their children received while in the care of the license. Parents stated they felt there children were well fed while in care of the licensee. In addition, the licensee indicated she ensures all children are fed in a timely manner, and has no knowledge of an child being left hungry. The licensee stated there has been a time where an infant was sick, and did want to eat, but she informed the parent of this instance an still offered the infant a bottle.

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 UNSUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency was cited on this report.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

LIC9099 (FAS) - (06/04)

Page: 7 of 8

Control Number 04-CC-20190903165950

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GONZALEZ, STEPHANIE FAMILY CHILD CARE	FACILITY NUMBER: 543909572
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/29/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 10/29/2019 Section Cited CCR 0000	1 2 3 4 5 6 7	*This deficency has been rescinded and therefore deleted.	1 2 3 4 5 6 7	*THIS IS AN AMENDED REPORT
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2020

LIC9099 (FAS) - (06/04)

Page: 8 of 8