198003781-12-5-2023-33-CC-ACHO-CYZ23R-20231229160247

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198003781
Report Date: 12/05/2023
Date Signed: 12/05/2023 10:01:23 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/05/2023 and conducted by Evaluator Monique Jessica Ayala

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20231005083332

FACILITY NAME:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	198003781
ADMINISTRATOR:	RODRIGUEZ, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 712-4224
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90028
CAPACITY:	14	CENSUS: 10	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Angelica Rodriguez, Licensee		TIME COMPLETED:	10:10 AM

ALLEGATION(S):

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Personal Rights: Day care child sustained eye injury due to licensee neglect

INVESTIGATION FINDINGS:

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On December 5, 2023, Licensing Program Analysts (LPAs) Monique Ayala and Staicy Perry conducted an unannounced complaint investigation for the above facility. A COVID-19 risk assessment was assessed prior to entering the facility. LPA met with licensee, Angelica Rodriguez who guided LPA on a tour of the facility. LPA observed 10 children in care.

During the investigation, LPA interviewed Child #2 (C2) and Child #3 (C3), Staff #1 (S1) to Staff #3 (S3) and interviewed Parent #1 (P1) to Parent #3 (P3). LPA was unable to interview alleged victim, Child #1 (C1), as Reporting Party did not return LPA Ayala’s calls or provide LPA Ayala with RP’s schedule to interview C1.

Reporting Party (RP) alleged, “Day care child sustained eye injury due to licensee neglect”. C1 sustained an eye injury to the left eye while at the facility after gaining access to a bottle of hot sauce. Per S1, she was on her lunch break in the dining room while the day care children were in the converted garage area. Per S1, C1 was brought into the home by S3 due to C1 having a behavioral episode. According to S1, C1

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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 33-CC-20231005083332

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198003781
	VISIT DATE: 12/05/2023

NARRATIVE

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ran into the dining room and grabbed a bottle of habanero sauce and shook it. Per S1, she noticed that C1, had drops of salsa on his shirt and removed C1’s shirt to rinse it out. S1 stated that she observed C1 rubbing the eye. S1 stated she asked C1 if his eye was bothering him and C1 stated yes. S1 stated that she took C1 into the bathroom to rinse out his eye with water. Per S1, C1’s eye was not swollen or red at the moment but did start to get swollen and red somewhat bruised throughout the day. Per S1, the incident occurred at approximately 2:30pm and C1 was picked up at 4:30pm. LPA asked S1 how long it took for her to realize C1’s eye was bothering him. Per S1, she noticed immediately. Per S3, she only brought C1 into the dining room and did not observe the incident occur. Per S2, she did not observe the incident occur as the children were still napping.

Based on interviews conducted, the above allegation is deemed UNSUBSTANITAED. Based on interviews conducted with staff, children and parents, the above allegations are Unsubstantiated. There is not enough evidence or witnesses to substantiate, therefore, allegations are rendered Unsubstantiated at this time. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged allegations occurred. At this time LPA is unable to make a determination that any violations occurred.

An exit interview was conducted with licensee, Angelica Rodriguez and a copy of this report, Notice of Site visit and Appeal Rights were provided on this day, 12/05/2023.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

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