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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603968
Report Date: 12/19/2022
Date Signed: 12/19/2022 05:00:28 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,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/23/2022 and conducted by Evaluator Charmaine Linley
PUBLIC
COMPLAINT CONTROL NUMBER: 08-CR-20220923170557

FACILITY NAME:A.B. JESSIE POLINSKY CHILDREN'S CENTERFACILITY NUMBER:
374603968
ADMINISTRATOR:ROSAS, ELIZABETHFACILITY TYPE:
721
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:204CENSUS: 25DATE:
12/19/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Elizabeth Rosas, Protective Services Program ManagerTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff did not prevent inappropriate touching between minors in care
INVESTIGATION FINDINGS:
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On December 19, 2022, at 9:45 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced complaint inspection at the above facility. LPA Linley met with Elizabeth Rosas, Protective Services Program Manager. The purpose of the inspection was to the deliver the findings of the complaint investigation. LPA Linley conducted a safety check on 09/30/2022 at 2:30 pm and no issues were found. Investigator Annette Renquist from the Community Care Licensing Investigative Branch conducted the investigation. The following were interviewed by Investigator Renquist for the complaint investigation: County Social Worker (CSW1), Protective Services Worker (PSW), and Client #1 (C1). LPA Linley interviewed four staff (S1-4). During the investigation, the following were reviewed: C1 and C2 Child History Report, Child History Report Summary, Staff Schedule, Personnel Report, and Investigative Branch Report SA0822-09154.

On 09/13/2022, Community Care Licensing (CCL) received an allegation that staff inappropriately
***CONTINUED ON NEXT PAGE
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ann Valenzuela
LICENSING EVALUATOR NAME: Charmaine Linley
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
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 4
Control Number 08-CR-20220923170557
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: A.B. JESSIE POLINSKY CHILDREN'S CENTER
FACILITY NUMBER: 374603968
VISIT DATE: 12/19/2022
NARRATIVE
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touched C1 in care and staff did not prevent inappropriate touching between C1 and C2 in care.

Confidential interviews revealed conflicting information. Confidential interviews revealed C2 touched C1 in their private parts. Conflicting information revealed that C2 did not touch C1 in their private parts. There were no witnesses to this allegation.

The allegation that staff did not prevent inappropriate touching between C1 and C2 in care, may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time.

An exit interview was conducted and appeal rights were discussed with Elizabeth Rosas. Due to printer malfunction, a copy of this report, along with the LIC 811, and appeal rights will be emailed to the Facility Administrator. A signed copy of this report will be kept in the Facility file.
SUPERVISORS NAME: Ann Valenzuela
LICENSING EVALUATOR NAME: Charmaine Linley
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4