336300653-9-26-2023-10-CC-DMUN-CWKUA3-20231013152400

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336300653
Report Date: 09/26/2023
Date Signed: 09/26/2023 02:02:11 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 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
09/20/2023 and conducted by Evaluator Jeanette Sanchez

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20230920101440

FACILITY NAME:	JIMENEZ FAMILY CHILD CARE		FACILITY NUMBER:	336300653
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	09/26/2023
		UNANNOUNCED	TIME BEGAN:	12:56 PM
MET WITH:	Rosaura Jimenez		TIME COMPLETED:	02:09 PM

ALLEGATION(S):

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Absence of Supervision

INVESTIGATION FINDINGS:

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On the date and time listed above, Licensing Program Analyst (LPA) Jeanette Sanchez arrived at the facility to initiate a 10 day complaint investigation. LPA met with Licensee Rosaura Jimenez. For the investigation, LPA toured facility, took census, and conducted interviews.

On 9/20/2023, a complaint allegation was reported to Community Care Licensing (CCL), stating that there was absence of supervision at the daycare. Specifically, that a child was able to leave through the front door of the facility unsupervised and was not located for over 40 minutes.

Per licensee, on the date of the incident, she had entered the kitchen to obtain a baby bottle and left the child unattended in the front living room. There is not a direct line of vision from the kitchen to the living room. Licensee obtained bottle from refridgerator and placed into the microwave. Due to the sound of the microwave fan, only faintly heard announcement of "front door" when it was opened. Upon deciding to

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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-20230920101440

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JIMENEZ FAMILY CHILD CARE	FACILITY NUMBER: 336300653
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/26/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/27/2023 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	102417 Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee will submit a written statement about steps to be taken to ensure children are supervised and how to avoid future incidents related to lack of supervision.
	8 9 10 11 12 13 14	Child was left unsupervised, at which point child exited the front door and subsequently was lost for over 40 minutes. This poses an immediate risk to the health, safety and personal rights of the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Deborah Mullen
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20230920101440

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: JIMENEZ FAMILY CHILD CARE	FACILITY NUMBER: 336300653
	VISIT DATE: 09/26/2023

NARRATIVE

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confirm sound, noticed child was missing. Front door was closed therefore did not immediately look outside. Per licensee, did search for child outside 3-4 times, even calling for child. An interview countered that information, saying that at no point was the licensee seen outside or heard calling for child. Licensee said that child was found by a neighbor and noticed he was found after parent arrived to the facility. Child was with neighbor and police in front yard.

Based on all the information obtained from pertinent parties the department has determined the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED

See LIC 9099-D deficiencies. A civil penalty was assessed.

An exit interview was conducted, and this report was reviewed with Licensee Rosaura Jimenez. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC9099 (FAS) - (06/04)

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