585405073-11-30-2021-13-CC-MAVS-C9BMH5-20211202083658

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 585405073
Report Date: 11/24/2021
Date Signed: 11/30/2021 08:33:01 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/19/2021 and conducted by Evaluator Bianca Mendez

COMPLAINT CONTROL NUMBER: 13-CC-20211019135625

FACILITY NAME:	MENDOZA, OFELIA FAMILY CHILD CARE HOME		FACILITY NUMBER:	585405073
ADMINISTRATOR:	MENDOZA, OFELIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 743-6715
CITY:	OLIVEHURST	STATE: CA	ZIP CODE:	95961
CAPACITY:	14	CENSUS: 8	DATE:	11/24/2021
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Ofelia Mendoza		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Child was provided medication without authorized representative permission.

INVESTIGATION FINDINGS:

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On 11/24/21 at 12:00pm, Licensing Program Analyst (LPA) Mendez conducted an unannounced complaint inspection and met with licensee Ofelia Mendoza. It was alleged that child was provided medication without authorized representative permission.
The licensee was interviewed on 10/21/21 at 11:00am and denied the allegation and stated that it is not true and does not give medication to children without parent's permission and a doctor's note. LPA Mendez asked licensee if she had given any children vitamins and licensee stated that she does not give children vitamins and has given children Pediasure to drink.
LPA Mendez interviewed four parents (P1-P4) on 10/21/21 and 10/25/21. LPA Mendez asked four parents if licensee gave children medication without their consent, three out of four parents stated no. Parent (P1) stated that licensee gave children medication to sleep. LPA Mendez asked four parents if licensee ever gave medication to children without their consent three out of four parents stated no. Parent (P1) stated that licensee did not have give their consent for licensee to give children C1 or C2 any medication.
continued 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca Mendez	TELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:	DATE: 11/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2021

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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Control Number 13-CC-20211019135625

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MENDOZA, OFELIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 585405073
	VISIT DATE: 11/24/2021

NARRATIVE

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LPA Mendez asked parents (P1-P4) if licensee gave their children vitamins without their consent three out of four parents stated no. Parent (P1) stated that melatonin may have been given to child (C1), she stated C1 was lethargic at pick. LPA Mendez asked parents (P1-P4) if they had any concerns regarding licensee, four out of four parents stated no.

During the visit LPA Mendez observed that licensee keeps medication in a cabinet located in the kitchen, the kitchen is inaccessible to children with the use of a baby gate. LPA Mendez toured the daycare room and observed 8 children present during the visit.

Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. An exit interview was conducted. The Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca Mendez	TELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:	DATE: 11/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2021

LIC9099 (FAS) - (06/04)

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