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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364843917
Report Date: 12/13/2022
Date Signed: 12/13/2022 04:56:27 PM

Substantiated


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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/24/2022 and conducted by Evaluator Diana Brasel
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20221024121859

FACILITY NAME:CORTEZ FAMILY CHILD CAREFACILITY NUMBER:
364843917
ADMINISTRATOR:CORTEZ, ELAINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 471-1348
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:14CENSUS: 11DATE:
12/13/2022
UNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Elaina Cortez Licensee TIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Licensee did not follow safe sleep protocols for infants in care.
INVESTIGATION FINDINGS:
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On the above noted date and time Licensing Program Analysts (LPA’s) Diana Brasel and Claudia
Caywood conducted an unannounced visit regarding the above allegation. On 11/01/22, an initial visit
was conducted, at which time, LPA discussed the allegation with the licensee, conducted interviews, and
records were obtained. On today’s date, LPA Brasel met with the licensee to deliver the concluded
finding. At time of visit LPA toured facility and conducted a census.

It was alleged the Licensee did not follow safe sleep protocols for infants in care.
During the tour of the facility on the initial visit, LPA observed a bouncy chair in a napping area for daycare
children, which is prohibited item. Licensee admitted the chair is used to assist with putting child to sleep. The licensee stated, once the child was asleep, the child would be placed on their back in a play yard. The licensee stated, she was not aware the bouncy chair was prhibited and immediately removed the bouncy chair at time of the initial visit
LIC 809D for deficiency. --continued on LIC 9099C-
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022
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 09-CC-20221024121859
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
VISIT DATE: 12/13/2022
NARRATIVE
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An exit interview was conducted with the Licensee. A Notice of Site visit was issued and shall be posted
in a prominent location at the facility. The licensees understand that it must remain posted for the next 30
days.

A copy of this report was provided to the licensee on this date and must be made available to the public
upon request for the next 3 years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 09-CC-20221024121859
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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/20/2022
Section Cited
CCR
102417(d)(1)
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Operation of a Family Child Care Home:
(d) The home shall provide safe toys, play equipment and materials.
(1) Fixtures, furniture and equipment that have been banned or recalled by the United States Consumer Protection Safety Commission shall not be used for
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The licensee removed the prohibited item on 11/01/2022 from the daycare area. The licensee has stated, she understands the item is a prohited item.

POC cleared on this date.
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children in care or accessible to children in care.
This requirement was not met as evidenced by: LPA observed a bouncy chair in a napping area for daycare children, which is prohibited item. This poses as a non-immediate Health and Safety risk.
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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: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5