<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216708
Report Date: 08/29/2024
Date Signed: 08/29/2024 03:32:14 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/17/2024 and conducted by Evaluator Gigi Reyes
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20240517125220
FACILITY NAME:CHAVEZ FAMILY CHILD CAREFACILITY NUMBER:
426216708
ADMINISTRATOR:YOLANDA CHAVEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 310-1795
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 10DATE:
08/29/2024
UNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Yolanda ChavezTIME COMPLETED:
03:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child sustained skull fructure
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/29/2024, at 2:50 PM, Licensing Program Analysts, (LPAs) Gigi Reyes and Joaquin Mendez conducted an unannounced insepction to conclude the complaint investigation at the above Family Child Care Home (FCCH). LPAs met with Licensee, Yolanda Chavez and explained the purpose and nature of the inspection. LPAs observed 10 children under the care of 2 staff, licensee and assistant.

On 5/18/2024, the Department received a complaint alleging that Child # 1 sustained a skull fracture while under the care of Licensee, Yolanda Chavez. The investigation was conducted by Investigave Bureau (IB) Investigator, Heidy Bendana. Investigation included interview with Child #1's sibling, parents, and licensee, it also included review of Medical Report and Police Report.


Continued on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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 17-CC-20240517125220
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CHAVEZ FAMILY CHILD CARE
FACILITY NUMBER: 426216708
VISIT DATE: 08/29/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Interview with Child # 2 (sibling of Child # 1 (C1) revealed that C1 fell at their residence. The Medical Report indicated that the skull fracture was consistent with a fall and was not life-threatening. The police report highlighted the inconsistencies between the statements of C1's parents,

Based on the interviews and reviews conducted, there is no evidence to support the claim that the injury resulted from neglect, lack of care and supervision by the licensee, Yolanda Chavez.

Although the above 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 above allegation is Unsubstantiated.

Exit interview conducted and report was reviewed with Licensee, Yolanda Chavez.

Notice of Site Visit was issued and must remain posted for 30 days.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2