<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 163911207
Report Date: 04/19/2021
Date Signed: 04/20/2021 10:47:21 AM

Unsubstantiated


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
03/03/2021 and conducted by Evaluator Kathy Pacheco
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20210303091856
FACILITY NAME:CERVANTES, MAYRA FAMILY CHILD CAREFACILITY NUMBER:
163911207
ADMINISTRATOR:CERVANTES, MAYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 772-9576
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:14CENSUS: 4DATE:
04/19/2021
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Mayra CervantesTIME COMPLETED:
01:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child engaged in inappropriate touching with another day care child
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/19/2021, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced follow up complaint inspection at the facility. LPA met with Licensee Mayra Cervantes. The purpose of the inspection was to deliver the findings for the above complaint allegation.

During the course of the investigation, LPA Pacheco conducted interviews with Licensee, day care children, and complainant. The interviews revealed inconsistencies in the above allegation. Although the allegtion may have happened or may be valid, there is not a preponderance of the evidence to prove a day care child engaged in inappropriate touching with another day care child; therefore, the allegation is unsubstantiated.

Per California Code of Regulations, Title 22, Division 12, no deficiency was cited today.

Exit interview was conducted with Licensee. LPA provided Licensee with copies of the following documents: Notice of Site Visit form (LIC 9213), Complaint Investigation Report (LIC 9099), and appeal rights. The LIC 9099 is required to remain in the facility for public review and the LIC 9213 is required to be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2021
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 1