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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 293624876
Report Date: 08/17/2023
Date Signed: 08/17/2023 02:36:16 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/15/2023 and conducted by Evaluator Matthew Gallo
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230615114256
FACILITY NAME:FARFAN, LORINDAFACILITY NUMBER:
293624876
ADMINISTRATOR:FARFAN, LORINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 823-7311
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95949
CAPACITY:14CENSUS: 3DATE:
08/17/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Lorinda FarfanTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Personal Rights: Licensee handled day care child in a rough manner.
Personal Rights: Licensee spoke inappropriately to a child in care.
INVESTIGATION FINDINGS:
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On 8/17/2023, Licensing Program Analyst (LPA) Matthew Gallo met with licensee Lorinda Farfan to deliver findings related to the complaint received on 6/15/2023. Upon arrival, LPA observed a census of 3 children, composed of 2 preschool children and 1 school aged child.

It was alleged that licensee handled a day care child in a rough manner, and that licensee spoke inappropriately to a child in care. During the investigation, LPA conducted observations, record review, and interviewed licensee, staff, and parents. Interviews with parents, staff, and children did not produce any corroborating accounts of the above alleged behavior. Additionally, interviewed children did not report feeling threatened or scared of Licensee while in care.

Based on the information obtained, the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove it. Notice of site visit was provided and shall remain posted for 30 days for parental review.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
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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