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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 243911774
Report Date: 04/11/2023
Date Signed: 04/11/2023 12:38:18 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
03/06/2023 and conducted by Evaluator Yesenia Fierro
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20230306153815
FACILITY NAME:SANCHEZ, SAMANTHA FAMILY CHILD CAREFACILITY NUMBER:
243911774
ADMINISTRATOR:SANCHEZ, SAMANTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 233-4018
CITY:MERCEDSTATE: CAZIP CODE:
95341
CAPACITY:14CENSUS: 6DATE:
04/11/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Samantha SanchezTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee failed to report adult resident being alleged of committing a crime.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 04/11/2023 Licensing Program Manager (LPM) Rene Mancinas and Licensing Program Analyst (LPA) Yesenia Fierro, conducted an unannounced complaint inspection to provide finding regarding the above allegation. LPA met with licensee Samantha Sanchez. LPA discussed and explained the allegation and finding.

LPA investigated the above allegation. LPA interviewed facility staff, reviewed law enforcement records and interviewed law enforcement officials. Although an incident did occur regarding the facility, licensee was advised by law enforcement officials to not contact the Department to avoid interrupting law enforcement investigation. LPA verified this information with law enforcement officials. Based on the information obtained throughout the investigation, the preponderance of evidence standard was not met, therefore the allegation is UNSUBSTANTIATED.

LPA informed licensee of reporting requirements and to contact the Department to report any incidents listed as reportable.

Per California Code of Regulations Title 22 Division 12 Chapter 3 no deficiency is being cited. Notice of Site to be posted for 30 days. Exit interview conducted with Licensee, Samantha Sanchez.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
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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