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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376100077
Report Date: 02/07/2023
Date Signed: 02/07/2023 11:53:03 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/28/2022 and conducted by Evaluator Selina Siao
COMPLAINT CONTROL NUMBER: 51-CC-20221028154804
FACILITY NAME:DE MELLO PACHECO, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376100077
ADMINISTRATOR:MARIA DE MELLO PACHECOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 525-2392
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY:14CENSUS: 9DATE:
02/07/2023
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Maria De Mello PachecoTIME COMPLETED:
10:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained unexplained injuries while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 02/07/2023 at 9:15am, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced inspection to deliver complaint findings for the above allegation. The initial inspection was conducted on 11/01/2022. Upon arrival, LPA met with Licensee, Maria De Mello Pacheco and helperTamires Santos. LPA observed a total of 9 children including 2 infants in the family room (main day care area).
It was alleged a daycare child (C1) sustained an unexplained scratch on the back and supracondylar fracture on the left arm injury while in care. During the course of the investigation, the Department conducted interviews with other public agency member, facility staff members and several current and prior day care parents. In addition, medical records were obtained and reviewed. Based on information gathered, it is unclear when or where the injury occurred as the child's parents denied the child being injured at their home and day care provider denied the child was injured at the daycare. There is not enough corroborating evidence to determine that the child sustained the unexplained injuries while in care, therefore, the above allegation is deemed unsubstantiated. A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
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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