336300371-1-6-2023-10-CC-CMAZ-CN9RKF-20230120120529

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336300371
Report Date: 01/06/2023
Date Signed: 01/06/2023 01:22:45 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
12/14/2022 and conducted by Evaluator Alaina Wilburn

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20221214145559

FACILITY NAME:	SHENOUDA FAMILY CHILD CARE		FACILITY NUMBER:	336300371
ADMINISTRATOR:	SHENOUDA,NESREEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(442) 226-6386
CITY:	SAN JACINTO	STATE: CA	ZIP CODE:	92582
CAPACITY:	14	CENSUS: 1	DATE:	01/06/2023
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Nesreen Shenouda		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Provider left day care child at school.

Provider did not communicate with day care child's authorized representative.

INVESTIGATION FINDINGS:

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At 12:45PM, on January 6, 2023 Licensing Program Analyst (LPA) Alaina Wilburn conducted an unannounced complaint visit, to deliver the findings on the above stated allegations.

Investigation consisted of: interview with licensee and potential witness.

On 12/14/2022, a complaint allegation was received by the Community Care Licensing (CCL) office that Provider left day care child at school and Provider did not communicate with day care child's authorized representative. Licensee stated that she arrived at the school at 1:55pm with her assistant. The children get out at 2:00pm. Licensee advised Child #1 (C1) was not in the designated pick up spot, and she got out to look for the child and could not locate C1. Licensee advised that two other children had to be picked up at another school as they got out by 2:11pm. By 2:20pm, Licensee still did not find C1, and she called the parent of C1 to advise of the situation, which subsequently caused Licensee to be late picking up the other

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)

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Control Number 10-CC-20221214145559

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: SHENOUDA FAMILY CHILD CARE	FACILITY NUMBER: 336300371
	VISIT DATE: 01/06/2023

NARRATIVE

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children. According to licensee, she communicated with the parent during drop off that she might take two children to a holiday event at a local church. Licensee advised once she made the decision to attend the event, she sent a text message to both parents with the church address for pick up. Since the alleged communication about the event was verbal between licensee and parent, there is no physical evidence to prove that there was advanced notification. LPA did observe a text message with the address for pick up, and a picture of C1 enjoying the holiday event.

Based on interviews conducted, the allegation that Provider left day care child at school and Provider did not communicate with day care child's authorized representative, 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 allegations are UNSUBSTANTIATED at this time.

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

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)

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