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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 293624876
Report Date: 05/03/2024
Date Signed: 05/03/2024 02:44:13 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
02/20/2024 and conducted by Evaluator Matthew Gallo
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240220143954
FACILITY NAME:FARFAN, LORINDAFACILITY NUMBER:
293624876
ADMINISTRATOR:FARFAN, LORINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 823-7311
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95949
CAPACITY:14CENSUS: 2DATE:
05/03/2024
UNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Lorinda FarfanTIME COMPLETED:
02:55 PM
ALLEGATION(S):
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Personal Rights: Licensee engaged in a physical altercation with a parent in the presence of day-care children.
INVESTIGATION FINDINGS:
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At 2:05pm on 5/3/2024, Licensing Program Analyst (LPA) Matthew Gallo met with licensee Lorinda Farfan to deliver findings of a complaint investigation into the above allegation. Upon arrival, LPA observed a total census of 2 children, consisting of 1 preschool child and 1 school aged child.

It was alleged the the licensee engaged in a physical altercation with a parent in the presence of day-care children. Throughout the investigation, LPA conducted observation, record review, and interviews with relevant parties. Through interview and record review, LPA determined that an incident involving physical contact between a parent and the licensee did occur at the licensee's home on 2/15/2024, and that a daycare child was present at the time. Available evidence does not meet the burden of proof to determine that the licensee initiated or escalated the incident, or that the child present at the time was witness to the event.

Report continues on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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 03-CC-20240220143954
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: FARFAN, LORINDA
FACILITY NUMBER: 293624876
VISIT DATE: 05/03/2024
NARRATIVE
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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. Exit interview conducted and report was reviewed with the licensee, Lorinda Farfan. A notice of site visit was given and must remain posted for 30 days. Appeal rights provided.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2