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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364845744
Report Date: 10/13/2022
Date Signed: 10/13/2022 02:29:57 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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/13/2022 and conducted by Evaluator Patricia Berry
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220913132814
FACILITY NAME:FOREST FAMILY CHILD CAREFACILITY NUMBER:
364845744
ADMINISTRATOR:FOREST,JOYCEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 677-8878
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:14CENSUS: 0DATE:
10/13/2022
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Joyce Forest/LicenseeTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Licensee left day-care child unattended.
Licensee spoke inappropriately in the presence of day-care child
INVESTIGATION FINDINGS:
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On 10/13/2022 at 2:45 pm, Licensing Program Analyst (LPA) Patricia Berry conducted a subsequent complaint investigation. LPA was granted access into the facility and met with Joyce Forest. LPA toured facility and took a census. No children were present during visit. Licensee has moved to another location.

It was alleged the licensee left a day-care child unattended and speaks inappropriately in the presence of day-care child. During the investigation, LPA toured the facility and interviewed all pertinent parties, including staff.

Staff stated the licensee will go upstairs from time to time during the day; however, staff stated the assistant is available to meet the children’s needs. Staff stated they have never heard the licensee speak inappropriately in the presence of the children.

(Cont on 9099C)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 09-CC-20220913132814
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: FOREST FAMILY CHILD CARE
FACILITY NUMBER: 364845744
VISIT DATE: 10/13/2022
NARRATIVE
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Staff stated the licensee has never used bad language around them or to them. Based on interviews conducted, there is conflicting information from what was stated to what is alleged; therefore, the allegations of licensee left a day-care child unattended and the licensee spoke inappropriately in the presence of the day-care child are unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.



Exit interview conducted with licensee, report, appeal rights, and Notice of Site Visit provided.


Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2