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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334846609
Report Date: 03/19/2026
Date Signed: 03/19/2026 11:43:26 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 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
03/02/2026 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20260302170002
FACILITY NAME:MELODY LANE CHILDREN'S CENTERFACILITY NUMBER:
334846609
ADMINISTRATOR:M.D. SOCORRO CAMACHO AYALAFACILITY TYPE:
860
ADDRESS:9191 COLORADO AVENUETELEPHONE:
(714) 944-9959
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY:93CENSUS: 20DATE:
03/19/2026
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Delmy Portillo, Licensee/ M. Socorro Camacho Ayala-DirectorTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Facility not meeting child's needs
Facility staff did not prevent child from being bullied.
INVESTIGATION FINDINGS:
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On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido conducted a subsequent complaint investigation to deliver final findings. An initial visit was conducted on 03/06/2026, at which time LPA conducted interviews and reviewed records. LPA met with facility representatives, Delmy Portillo, Licensee/ M. Socorro Camacho Ayala-Director toured the facility and took a census.
During the investigation, LPA reviewed records and interviewed pertinent parties, including facility staff and children.
It was alleged facility is not meeting a child's needs in providing toileting assistance. Staff interviews reported conflicting information in that staff do visual checks, give verbal reminders and provide physical assistance (wiping/changing) for toileting needs.
It was alleged that facility staff did not prevent child from being bullied by a peer. It was reported the peer grabbed subject child and held them down. Pertinent party interviews reported conflicting information in that subject child was the aggressor and hit a peer in the face resulting in the peer extending their arm to prevent further contact and allow space.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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 09-CC-20260302170002
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MELODY LANE CHILDREN'S CENTER
FACILITY NUMBER: 334846609
VISIT DATE: 03/19/2026
NARRATIVE
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Due to conflicting information obtained from what was alleged, the evidence collected was not sufficient to substantiate or refute the above allegation. Although the allegation 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.
An exit interview was conducted, a copy of this report and Notice of Site Visit was provided to the facility representative, Delmy Portillo and M. Socorro Camacho Ayala.
LPA observed the Notice of Site Visit was posted by staff. THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2