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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334845683
Report Date: 01/06/2023
Date Signed: 01/06/2023 12:18:31 PM

Unsubstantiated


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
11/15/2022 and conducted by Evaluator Alaina Wilburn
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20221115125547
FACILITY NAME:YISRAEL FAMILY CHILD CAREFACILITY NUMBER:
334845683
ADMINISTRATOR:SARAHYAH YISRAELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 609-7876
CITY:SAN JACINTOSTATE: CAZIP CODE:
92582
CAPACITY:14CENSUS: 2DATE:
01/06/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Sarahyah YisraelTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Day-care child was choked by an adult in the home

Uncleared Adult in the home
INVESTIGATION FINDINGS:
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At 11:30AM,.on January 6, 2023, Licensing Program Analyst (LPA) Alaina Wilburn conducted an unannounced complaint visit. LPA met with Licensee Sarahyah Yisrael, to deliver findings on the above stated allegations.

Investigation consisted of; interviews with Licensee, Asistant, Day Care Children, Child #1 (C1) and potential witnesses.

On 11/15/2022, a complaint allegation was received by the Community Care Licensing (CCL) office that day-care child was choked by an adult in the home and an uncleared Adult in the home. Licensee, Assistant and day care children deny observing anyone choke C1. The Adult who is alleged to have choked C1 does not reside in the home and was unavailable for an interview. As for the second allegation, LPA received conflicting information regarding the uncleared adult present in the home; however, during the initial inspection on 11/21/2022, LPA Wilburn toured Licensee bedroom, closet and bathroom and did not observe
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
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 10-CC-20221115125547
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: YISRAEL FAMILY CHILD CARE
FACILITY NUMBER: 334845683
VISIT DATE: 01/06/2023
NARRATIVE
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any male clothing. In addition, Licensee submitted LPA a copy of a lease agreement for a separate address, where this individual is listed as a co-occupant with an effective date of 10/27/2022.

Based on interviews and observation conducted, the allegation that day-care child was choked by an adult in the home, and there is an uncleared Adult in the home, may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted and a copy of the report along with the appeal rights were provided to Licensee Sarahyah Yisrael.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2