334845863-7-28-2022-09-CC-AROS-CHDTXT-20220817150738

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334845863
Report Date: 07/28/2022
Date Signed: 07/28/2022 11:54:31 AM

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 ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/19/2022 and conducted by Evaluator Samuel Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20220519104732

FACILITY NAME:	HOLMES FAMILY CHILD CARE		FACILITY NUMBER:	334845863
ADMINISTRATOR:	HOLMES,ANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 449-4911
CITY:	CATHEDRAL CITY	STATE: CA	ZIP CODE:	92234
CAPACITY:	14	CENSUS: 12	DATE:	07/28/2022
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Ana Holmes		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Personal Rights - Child sustained injuries while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to conduct an inspection regarding a complaint received concerning the above allegation. LPA was given access to the facility by the Licensee Ana Holmes. LPA toured the facility and took a census. LPA met with Ana Holmes to further discuss the complaint/allegation. Previously, on 5/24/2022, an inspection was conducted regarding the complaint, on that visit, interviews were conducted, and files were reviewed.

The following was alleged: A child was bitten on the shoulder by another child and had an unexplained mark on their abdomen.

The Licensing Program Analyst (LPA) Samuel Lopez investigated the above allegation and gathered the following information: On May 18, 2022, there was an exchange between two children at the facility. One of the children grabbed the other and pulled on their shirt. The child who had their shirt pulled, turned around towards the other child, and bit the child on the shoulder.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2022

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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Control Number 09-CC-20220519104732

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: HOLMES FAMILY CHILD CARE	FACILITY NUMBER: 334845863
	VISIT DATE: 07/28/2022

NARRATIVE

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The child not only had a bite mark, but also another reddish mark on their stomach area, that was observed by the licensee during a diaper change. However, what caused the mark could not be explained by the parent/legal guardian nor the licensee. The biting incident was observed and could not be prevented, according to the licensee. Also, per the licensee, and prior to the incident, the child that was bit had been exhibiting challenging behavior. The child had been throwing toys around, which had been observed by another child in care, and hitting their own head against the walls of the facility’s playroom. The behavior had been reported to the parent/legal guardian and assumed that it was possibly due to a new environment, given that the child had only been at the facility for a few days. The licensee had already decided to terminate care of the child prior to the incident. The day of the incident the licensee informed the parent/legal guardian that the care/contract would be terminated two days later (5/20/2022). According to the licensee, the child did not return after the incident, and no reason was given. Additional information regarding the need for or if medical attention was obtained for the bite and/or mark on the stomach was not provided.

Although the allegation of Personal Rights may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Licensee Ana Holmes.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2022

LIC9099 (FAS) - (06/04)

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