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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334842209
Report Date: 01/17/2024
Date Signed: 01/17/2024 12:46:23 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
11/01/2023 and conducted by Evaluator Cindy Hamilton
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20231101102849
FACILITY NAME:MARTINEZ SERENA FAMILY CHILD CAREFACILITY NUMBER:
334842209
ADMINISTRATOR:MARTINEZ SERENA, LORENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 285-5466
CITY:SAN JACINTOSTATE: CAZIP CODE:
92583
CAPACITY:14CENSUS: 3DATE:
01/17/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Lorena Martinez SerenaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Licensee is not following a licensed physician’s order for a daycare child.
INVESTIGATION FINDINGS:
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On January 17, 2023, at 12:05 p.m., Licensing Program Analyst (LPA) Cindy Hamilton met with licensee Lorena Martinez Serena to deliver the findings for the above stated allegation.  During the investigation, LPA Hamilton conducted interviews with five children, licensee, two parents and reporting party.  LPA Hamilton conducted a health and safety inspection of the CCC on November 7, 2023 and December 28, 2023, and no safety concerns were noted.  LPA obtained and reviewed pertinent documentation.

On November 1, 2023, Community Care Licensing (CCL) received information stating that licensee is not following a licensed physician’s order for a daycare child. It was alleged that licensee fed Child #1 (C1) milk when C1’s parent and a physician specified C1 is to drink soy/almond milk due to C1’s milk allergy. A Confidential interview with the licensee disclosed that the licensee did provide C1 with 1% milk because she did not have almond milk in the FCCH at the time, and the parent had not submitted the required medical statement to request special meals and/or accommodations for the food program.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
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 7
Control Number 10-CC-20231101102849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MARTINEZ SERENA FAMILY CHILD CARE
FACILITY NUMBER: 334842209
VISIT DATE: 01/17/2024
NARRATIVE
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 During initial inspection, LPA reviewed C1’s file, and noted that the documentation did not list any allergies, however, further interviews revealed that C1’s parent had advised the licensee not to give C1 any milk due to allergy but the licensee did so and C1 did not show any symptoms of an allergic reaction.

Based on records review, the preponderance of evidence has been met and the allegation that Licensee is not following a licensed physician’s order for a daycare child is substantiated. The facility is being cited for Title 22, Section 102423(a)(4) Personal Rights which poses a potential health, safety and/or personal rights risk to children in care.

An exit interview was conducted, a copy of this report, Appeal Rights and Notice of Site Visit were provided to licensee. The licensee was reminded that the Notice of Site visit must remain posted for 30 consecutive days and violation of this regulation may result in civil penalties.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 10-CC-20231101102849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: MARTINEZ SERENA FAMILY CHILD CARE
FACILITY NUMBER: 334842209
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2024
Section Cited
CCR
102423(a)(4)
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Section 102423(a)(4) Personal Rights (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived...These rights include, but are not limited to, the following: (4) To be free from corporal or unusual punishment, infliction of pain... including, but not limited to: interference with eating, sleeping or toileting...or aids to physical functioning. This requirement was not met as evidenced by:
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Licensee has agreed to provide a statement that licensee will not provide food or milk to children as requested by parent and/or as directed by documentation provided by a licensed medical provider. Licensee provided statement to LPA during inspection.
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Based on confidential interview and records review, C1 was served milk that C1 was allergic to which poses a potential health, safety and/or personal rights risk to children in ca
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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: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
11/01/2023 and conducted by Evaluator Cindy Hamilton
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20231101102849

FACILITY NAME:MARTINEZ SERENA FAMILY CHILD CAREFACILITY NUMBER:
334842209
ADMINISTRATOR:MARTINEZ SERENA, LORENAFACILITY TYPE:
810
ADDRESS:1241 DA VINCI DRIVETELEPHONE:
(951) 285-5466
CITY:SAN JACINTOSTATE: CAZIP CODE:
92583
CAPACITY:14CENSUS: DATE:
01/17/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Lorena Martinez SerenaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Licensee yells at the daycare children.
Licensee does not properly observe ill daycare children while in care.
Licensee discloses confidential information about the daycare children
INVESTIGATION FINDINGS:
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On January 17, 2023, at 12:05 p.m., Licensing Program Analyst (LPA) Cindy Hamilton met with licensee Lorena Martinez Serena to deliver the findings for the above stated allegation.  During the investigation, LPA Hamilton conducted interviews with five children, licensee, two parents and reporting party.  LPA Hamilton conducted a health and safety inspection of the CCC on November 7, 2023 and December 28, 2023, and no safety concerns were noted.  LPA obtained and reviewed pertinent documentation.

On November 1, 2023, Community Care Licensing (CCL) received information stating that licensee yells at daycare children, licensee does not properly observe ill daycare children while in care, and licensee discloses personal information about the daycare children. Regarding the allegation that licensee yells at daycare children, it was alleged that the licensee is mean and yells at the children consistently. Confidential interviews resulted in conflicting information being provided to LPA. Confidential interviews disclosed that the licensee sometimes yells at the children, however, on most instances she was trying to get their attention and was trying to get them to do what they were asked so she had to raise her voice and
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 10-CC-20231101102849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MARTINEZ SERENA FAMILY CHILD CARE
FACILITY NUMBER: 334842209
VISIT DATE: 01/17/2024
NARRATIVE
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change her tone. Other confidential interviews disclosed that the licensee has not been witnessed yelling at any of the children for any reason.

Regarding the allegation that licensee does not properly observe ill children while in care, it was alleged that licensee consistently lets sick children come to daycare and other children get sick. Confidential interviews revealed that licensee does not allow children to attend the FCCH if they are sick, and parents were required to keep their children at home. Further interviews revealed that children in the daycare were getting sick while attending, however, due to the licensee’s strict policy, it was unknown how they would get sick while attending the FCCH.

Regarding the allegation licensee discloses personal information about daycare children, it was alleged that licensee is speaking to parents regarding other daycare children. Licensee denied this allegation. Confidential interviews disclosed that the licensee had made a comment about a child to a another parent, however, no personal information was discussed and no health information was divulged.

Based on confidential interviews and records review, the allegations licensee yells at daycare children, licensee does not properly observe ill daycare children while in care, and licensee discloses personal information about the daycare children, may have occurred, however are not supported or proven by evidence. Therefore, the allegations are unsubstantiated.

An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit were provided to the licensee Lorena Martinez Serna. Licensee was reminded that the Notice of Site Visit must remain posted for 30 consecutive days and violation of this regulation may result in civil penalties.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC9099 (FAS) - (06/04)
Page: 7 of 7