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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 243909601
Report Date: 12/06/2023
Date Signed: 12/06/2023 01:02:09 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 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
10/03/2023 and conducted by Evaluator Priscilla Zamudio
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20231003065829
FACILITY NAME:QUIROZ, CARMEN FAMILY CHILD CAREFACILITY NUMBER:
243909601
ADMINISTRATOR:QUIROZ, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 398-0644
CITY:LIVINGSTONSTATE: CAZIP CODE:
95334
CAPACITY:14CENSUS: 3DATE:
12/06/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Carmen Quiroz TIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child was touched inappropriately by an adult
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/6/23, Licensing Program Analyst (LPA) Priscilla Zamudio conducted a complaint inspection to deliver the finding regarding the above allegation. LPA met with Licensee, Carmen Quiroz. LPA toured the facility, inside and outside and a census was taken of 3 children.

The Department of Social Services Investigations Branch (IB) conducted the investigation into the above allegation. During the course of the investigation, IB Investigator Ruben Munoz interviewed the Licensee, staff, children, and parents. Investigator also obtained and reviewed facility records and pertinent information related to the above allegation. Based on the investigation conducted by IB Investigator Munoz, although the above allegation may have happened or is valid, there is not a preponderance of evidence at this time to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency is cited during today’s inspection. Exit interview conducted with Licensee Carmen Quiroz. A Notice of Site Visit was provided.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
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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