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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 573616571
Report Date: 12/23/2019
Date Signed: 12/23/2019 11:43:25 AM



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
10/09/2019 and conducted by Evaluator Marissa Soto
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20191009113408
FACILITY NAME:NUNEZ, SANDRAFACILITY NUMBER:
573616571
ADMINISTRATOR:NUNEZ, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 668-0462
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:14CENSUS: 0DATE:
12/23/2019
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sandra NunezTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee denied child's authorized representative information about the child.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This is an amended report of original report dated 12/23/19.
Licensing Program Analyst (LPA) Marissa Soto met with, Licensee Sandra Nunez, for the purpose to delivering findings for the above complaint allegation. Upon arrival there were no children present. During the investigation, interviews were conducted with Licensee, Licensee’s husband, the child’s mother and parents. Through the interview process, Licensee admitted that she was instructed by the child’s mother not to provide information regarding child to the father of the child. Mother of the child also admitted that she instructed Licensee not to provide information to the father because the parents of the child share joint custody and the child care falls on the mother’s days and hours. Licensee stated that she has never met the father of the child, has never heard his voice. Licensee stated that when she received a telephone call, Licensee stated she stated that the child was fine, however could not disclose any information, especially to someone who she has never met, Licensee stated she was unable to confirm the identity and relationship to the child in question. The agency has investigated the complaint allegation above. This complaint has been determined to be UNSUBSTANTIATED: meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occured.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Marissa SotoTELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2019
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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