361880963-5-10-2023-56-AS-KCLS-CS4MPM-20230523094719

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880963
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:13:07 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/08/2023 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230508151548

FACILITY NAME:	ESPERANZA'S PLACE		FACILITY NUMBER:	361880963
ADMINISTRATOR:	AGUILAR, DANETTE		FACILITY TYPE:	735
ADDRESS:	12104 MODOC PLACE		TELEPHONE:	(714) 483-8057
CITY:	CHINO	STATE: CA	ZIP CODE:	91710
CAPACITY:	4	CENSUS: 4	DATE:	05/10/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Eric Aguilar		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff does not ensure shower is free of mold

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint regarding an allegation that staff does not ensure shower is free of mold. LPA Prieto met with staff Eric Aguilar, explained the elements of the investigation and toured the facility. LPA toured the bathroom in question and found it to be clean and free from mold, was clean and sanitary. Interview with staff stated that facility is cleaned on a regular basis.

Based on the information obtained there is not enough evidence that staff does not ensure shower is free of mold . Therefore, the allegations is deemed UNSUBSTANTIATED at this time. 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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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