197413473-4-29-2022-12-CC-MRAN-CEVB3W-20220529004348

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197413473
Report Date: 04/29/2022
Date Signed: 04/29/2022 04:35:32 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/17/2022 and conducted by Evaluator Justeene Tamayo

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20220317121709

FACILITY NAME:	VAZQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	197413473
ADMINISTRATOR:	VAZQUEZ, PATRICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 722-0946
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	14	CENSUS: 6	DATE:	04/29/2022
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Janessa Vazquez		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Personal Rights: Minor sustained unexplained injuries while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Justeene Tamayo and Licensing Program Manager (LPM) Mariela Ramon met with staff member Janessa Vazquez. During the visit, licensee came shortly after for the purpose of concluding the investigation concerning the above complaint allegation.

The investigation consisted of interviews with licensee, staff, children, and other complaint relevant parties including law enforcement personnel.

On or about March 15, 2022, it was alleged that child was picked up at the facility by child’s guardian who observed unexplained injuries on the child.

Please see Complaint Investigation Report LIC9099C for additional information.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022

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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Control Number 12-CC-20220317121709

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VAZQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197413473
	VISIT DATE: 04/29/2022

NARRATIVE

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Interviews conducted revealed there was no corroborating evidence to prove that child sustained bruising on both ears, bruising on the right side of the neck, and a scratch on the child’s cheek while in care. It was alleged child’s guardian observed blood stains on the child’s shirt.

During an interview with staff at the facility, it was revealed during the incident on 03/15/22, child was picking his nose and, in the process made his nose bleed. This was observed by a facility staff who was responsible for supervising the children. The Regional Office obtained photographs of the child on the day of the incident and observed minor blood stains on the child’s shirt which is consistent with the child picking his nose which resulted in minor bleeding.

Based on interviews conducted, there is not enough evidence or witnesses to substantiate the allegation of Personal Rights, therefore, the allegation is rendered Unsubstantiated at this time. A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged allegation occurred.

An exit interview was conducted, and a copy of this report was read and provided to the Licensee on this date.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022

LIC9099 (FAS) - (06/04)

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