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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336300474
Report Date: 04/13/2023
Date Signed: 04/13/2023 02:14:49 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
03/06/2023 and conducted by Evaluator Sumayya Habeebulla
COMPLAINT CONTROL NUMBER: 10-CC-20230306132710
FACILITY NAME:VICTOR FAMILY CHILD CAREFACILITY NUMBER:
336300474
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
04/13/2023
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Consuelo VictorTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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- Day care child sustained injuries due to staff neglect
- Licensee is not meeting day care child's diapering needs
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Sumayya Habeebulla and William Chancellor arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 03/06/23. LPAs met with Licensee Consuelo Victor and discussed the above allegations.

On 03/13/23 LPA Habeebulla conducted interviews with Licensee and along with interviews, the investigation revealed that:

See LIC 9099C for continuation
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
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 5
Control Number 10-CC-20230306132710
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: VICTOR FAMILY CHILD CARE
FACILITY NUMBER: 336300474
VISIT DATE: 04/13/2023
NARRATIVE
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There is an allegation that the Day care child sustained injuries due to staff neglect. According to the licensee, the child was enrolled at the daycare for approximately 4 days and had a visible rash the first day the C1 was brought into the daycare. In addition, the parent informed the licensee that the child had sensitive skin and requested that the child be changed every hour and a half. Based on the information obtained through interviews, LPA was unable to corroborate allegation and could not determine if the rash/blisters were sustained at the facility, or if the child has had a rash from the time of enrollment due to conflicting information obtained.

The second allegation is of Licensee not meeting day care child's diapering needs. Pertinent interviews revealed that the facility ensures all children in care are changed every 2 hours or earlier if needed. At the request of the parent, the Licensee stated that C1’s diaper was changed every hour and a half or earlier if soiled and was checked on regularly, especially since the child had a rash from the moment C1 arrived at the facility. The licensee stated that she made it a point to pay extra attention to C1 because she wanted to ensure the rash did not get any worse.

From the information received by interviews with pertinent parties the above allegations cannot be verified. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the allegations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Licensee Consuelo Victor, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
03/06/2023 and conducted by Evaluator Sumayya Habeebulla
COMPLAINT CONTROL NUMBER: 10-CC-20230306132710

FACILITY NAME:VICTOR FAMILY CHILD CAREFACILITY NUMBER:
336300474
ADMINISTRATOR:VICTOR, CONSUELOFACILITY TYPE:
810
ADDRESS:10257 FERNLEAF DRTELEPHONE:
(310) 619-1999
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:8CENSUS: 5DATE:
04/13/2023
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:TIME COMPLETED:
02:25 PM
ALLEGATION(S):
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9
- Licensee is using inappropriate day care equipment
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Sumayya Habeebulla and William Chancellor arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 03/06/23. LPAs met with Licensee Consuelo Victor and discussed the above allegations.

On 03/13/23 LPA Habeebulla conducted interviews with Licensee and along with interviews, the investigation revealed that:

See LIC 9099C for continuation
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 10-CC-20230306132710
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: VICTOR FAMILY CHILD CARE
FACILITY NUMBER: 336300474
VISIT DATE: 04/13/2023
NARRATIVE
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The third allegation is of Licensee is using inappropriate day care equipment. During LPA’s initial visit on 03/13/23, it was observed the facility had a walker on premises being used for C2 as per the request of C2’s parent. Licensee stated she has never allowed any other children to use the walker and LPA was unable to verify if C1 ever used it. The Licensee was reminded that childcare facilities cannot use walkers, bouncers, or exersaucers, and the walker was removed and returned to the parent on 03/13/23.

Based on LPAs observation, the allegation is SUBSTANTIATED.

An exit interview was conducted with Licensee Consuelo Victor, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20230306132710
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: VICTOR FAMILY CHILD CARE
FACILITY NUMBER: 336300474
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/13/2023
Section Cited
CCR
102471(g)(10)
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A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).This requirement was not met as evidenced by:
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Based on observation and interviewson 03/13/23 it was observed facility has been using a walker/Exersaucer in the premise which poses a potential, heath, safety or personal rights risk to children in care.
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LPA observed on 04/13/23 that the walker is not longer at the facility. Licensee has removed the walker from the premises on 03/13/23.
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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: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5