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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343617899
Report Date: 07/03/2025
Date Signed: 07/03/2025 10:51:47 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/30/2025 and conducted by Evaluator Fabian Schwartz
COMPLAINT CONTROL NUMBER: 03-CC-20250630163832
FACILITY NAME:BEJAR, IVONNEFACILITY NUMBER:
343617899
ADMINISTRATOR:BEJAR, IVONNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 752-8028
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:14CENSUS: 11DATE:
07/03/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Paula Gomez RiveraTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Licensee is not present at the facility the required amount of time - Substantiated
INVESTIGATION FINDINGS:
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On Thursday 3 July 2025, at approximately 9:30am Licensing Program Analyst (LPA) Fabian Schwartz met with Licensee's Assistant Paula Gomez Rivera to open and close a complaint investigation. LPA delivered findings of investigation at end of investigation. At time of inspection there were 11 children, 1 of which is an infant being supervised by 2 of Licensee's Assistants.

The department received a complaint alleging that Licensee is not present at the facility the required amount of time. During today’s inspection, LPA made observations and conducted interviews. During today's inspection, Assistant's interviews confirmed that licensee has not been in facility today and would return tomorrow. Based on the interview and facility's operating status today, the preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

Report Continued on LIC9099-C........
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
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 3
Control Number 03-CC-20250630163832
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BEJAR, IVONNE
FACILITY NUMBER: 343617899
VISIT DATE: 07/03/2025
NARRATIVE
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Report Continued from LIC9099.....


1 Type A Title 22 deficiency is being cited for Licensee not being present in the facility for at least 20% of the operating day. That citation is being explained in more detail on accompanying LIC9099-D Page.

Title 22 deficiencies are cited on the subsequent pages of this report. Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, Licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Facility. LIC 9224 and Appeal Rights were provided. Licensee's signature on this report acknowledges receipt of these rights.

This report was reviewed with Licensee's assistant and an exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20250630163832
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: BEJAR, IVONNE
FACILITY NUMBER: 343617899
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/04/2025
Section Cited
CCR
102417(a)
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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. When circumstances require the licensee to be temporarily absent from the home, the
licensee shall arrange for a substitute adult to care for and supervise the children during his/her
absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing
care per day.

This requirement is not met as evidenced by:
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Licensee will review licensing requirements for presence in facility, and if Licensee is not home, they will not operate childcare in the future.
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Based on observation and interview, the facility did not comply with the section cited above by licensee not being present in home for the required amount of time during facility operation which poses an immediate health, safety or personal rights risk to persons in care.
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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: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3