198014215-7-29-2026-33-CC-KCHE-DWLQHT-20260803121140

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198014215
Report Date: 07/28/2026
Date Signed: 07/29/2026 03:35:13 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 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
05/22/2026 and conducted by Evaluator Monica Ruiz

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20260522124437

FACILITY NAME:	RUBALCABA FAMILY CHILD CARE		FACILITY NUMBER:	198014215
ADMINISTRATOR:	RUBALCABA, GRACIELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 604-9050
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90063
CAPACITY:	12	CENSUS: 7	DATE:	07/28/2026
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Licensee, Graciela Rubalcaba		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Licensee did not adhere to safe sleep practices.

INVESTIGATION FINDINGS:

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On July 27, 2026, Licensing Program Analyst (LPA) Monica Ruiz conducted an unannounced complaint investigation to deliver findings and met with Graciela Rubalcaba, Licensee, to whom the reason for the visit was explained. LPA observed 7 children in care with Licensee and Assistant (S1).
Children’s names were recorded (LIC 811). Adults in the home have fingerprint clearance and names were recorded see LIC 811 - Confidential Names.
During this investigation, LPA interviewed children, parents, Licensee and staff.

LPA reviewed facility records, including but not limited to the children’s rosters, resource and referral agency contracts, staff and children’s files, Safe Sleep Logs, and obtained other pertinent documents.

According to the complaint filed by the Reporting Party (RP), Licensee did not adhere to safe sleep practices.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Monica Ruiz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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-20260522124437

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: RUBALCABA FAMILY CHILD CARE	FACILITY NUMBER: 198014215
	VISIT DATE: 07/28/2026

NARRATIVE

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LPA Ruiz conducted unannounced visits to the facility noted above and observed the facility’s nap time routine and Safe Sleep practices. Licensee states that currently there are no infants in care.

LPA visited the facility during nap time and observed child 6 (C6) napping in bedroom #1. Child 6 (C6) was sleeping in a play pen in bedroom #1, face up, with no toys, bumpers, or bottles in the crib. C6 is not an infant. Licensee states that C6 likes to cover their face while sleeping and that they remove the cover but C6 puts it back on their face. LPA discussed Safe Sleep regulation and requirements with Licensee. Licensee states that C6 now sleeps on a cot during nap time.

LPA Ruiz interviewed Children 1,2,4,5 and 7 and no disclosures were made supporting the allegation made by RP.

LPA Ruiz conducted parent interviews. Parents 1, 2, 5 stated that they are happy with care that the Licensee provides and had no concerns. Parents 3 and 4 did not return LPA’s calls.

Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies are being cited at this time. An exit interview was conducted with Graciela Rubalcaba. Appeal Rights were discussed, and a copy was provided. The Notice of Site Visit (LIC 9213) was issued.

SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Monica Ruiz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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