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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020244
Report Date: 08/01/2023
Date Signed: 08/01/2023 10:51:41 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 CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/09/2023 and conducted by Evaluator Jeanette Estrada
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20230509091233
FACILITY NAME:FERNANDO FAMILY CHILD CAREFACILITY NUMBER:
198020244
ADMINISTRATOR:SHAMILA & TERVINE FERNANDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 728-7251
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 7DATE:
08/01/2023
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Licensees Shamila and Trevine Fernando TIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
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9
Personal Rights
INVESTIGATION FINDINGS:
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Licensing program analyst (LPA) Jeanette Estrada conducted an unannounced complaint investigation for the purpose of delivering findings for the allegation listed above. LPA met with Licensees Shamila and Trevine Fernando. LPA observed 7 children present during today's inspection.
During the course of the investigation LPA conducted interviews with children, parents, staff and the reporting party. LPA collected and reviewed pertinent documents such as the facility roster which identified Child 1 and Child 2. Interviews conducted with children and parents did not corroborate the allegations. Based on conflicting statements made by all parties interviewed, the LPA is unable to determine whether the allegations occured.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
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 2
Control Number 54-CC-20230509091233
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FERNANDO FAMILY CHILD CARE
FACILITY NUMBER: 198020244
VISIT DATE: 08/01/2023
NARRATIVE
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Page 2
Exit interview was conducted with Licensees. A copy of the appeal rights (LIC9058 01/16) were provided and explained. A copy of the report and the Notice of Site Visit was provided to the Licensees. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2