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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334817477
Report Date: 05/02/2025
Date Signed: 05/05/2025 10:02:15 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/19/2025 and conducted by Evaluator Brian Morris
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20250319131610
FACILITY NAME:FIGUEROA FAMILY CHILD CAREFACILITY NUMBER:
334817477
ADMINISTRATOR:FIGUEROA, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 656-2199
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:14CENSUS: 13DATE:
05/02/2025
UNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Licensee, Carmen FigueroaTIME COMPLETED:
11:55 AM
ALLEGATION(S):
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Licensee does not ensure day care child has valid immunization records.
INVESTIGATION FINDINGS:
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On May 2, 2025, at 10:55 AM, Licensing Program Analyst (LPA) Brian Morris arrived at the facility for the purpose of delivering findings on compliant investigation initiated on 03/19/25. LPA met with Licensee Carmen Figueroa on 05/02/2025 and took census of children in care there are 13 children in care and 3 staff supervising. LPA also took a tour of the facility and observed supervision of children in care, and staff interactions and staff supervision.

During initial inspection, LPA reviewed records of children in care and observed that C1 was enrolled in the daycare on 08/25/24 and did not observe the required immunizations on file. LPA interviewed the Licensee, and she confirmed that C1 had been enrolled in the faciility since August 2024 and did not receive the immunizations from the parent.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Brian Morris
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
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 3
Control Number 10-CC-20250319131610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: FIGUEROA FAMILY CHILD CARE
FACILITY NUMBER: 334817477
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/02/2025
Section Cited
CCR
102418(a)
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102418(a) Immunizations: Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.
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Licensee confirmed that C1 was disenrolled on 03/24/25. Licensee agreed to submit a written statement acknowledging regulation and requirement to obtain immunization records prior to admission to daycare.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Brian Morris
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20250319131610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FIGUEROA FAMILY CHILD CARE
FACILITY NUMBER: 334817477
VISIT DATE: 05/02/2025
NARRATIVE
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Based on investigation findings, the allegation that Licensee does not ensure day care child has valid immunization records will be closed as SUBSTANIATED. The preponderance of evidence has been met. An exit interview was conducted and a copy of this report, appeals rights and notice of site visit were provided to Licensee Carmen Figueroa. Licensee Carmen Figueroa was reminded that the notice of site visit must remain posted for 30 consecutive days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Brian Morris
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3