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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013423006
Report Date: 08/01/2022
Date Signed: 08/01/2022 11:48:10 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/26/2022 and conducted by Evaluator Sidney Cortez
COMPLAINT CONTROL NUMBER: 52-CC-20220726113029
FACILITY NAME:PENA RAMIREZ, JOSEFACILITY NUMBER:
013423006
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
08/01/2022
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Jose Pena RamirezTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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9
Level of Care--Daycare Child had lice.
INVESTIGATION FINDINGS:
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On Aug 1, 2022 , Licensing Program Analyst (LPA) Sidney Cortez conducted an unannounced complaint site inspection. LPA met with licensee and informed him about the allegation towards his daycare, that daycare chidlren had lice.

Allegation was under the category of: Level of Care. LPA took a tour of the facility for a health and safety inspection. Present during the inspection was the licensee and 5 school age children.
LPA Cortez requested and obtain a copy of the facility roster and personnel report. LPA conducted interviews with the licensee.

Based on the interviews conducted, files obtained, and observation, the allegation that a daycare child had lice is unsubstantiated meaning there was no preponderance of evidence to prove the alleged violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2022
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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