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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493008907
Report Date: 07/23/2021
Date Signed: 07/23/2021 11:54:54 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/14/2021 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20210714111458
FACILITY NAME:NOVOA, LORENA FCCHFACILITY NUMBER:
493008907
ADMINISTRATOR:NOVOA, LORENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 322-1425
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY:14CENSUS: DATE:
07/23/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Lorena NovoaTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained injuries while in care
Licensee did not notify day care child's authorized representative of incidents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced complaint investigation inspection was made to the facility by Licensing Program Analyst (LPA) Amy Strother. LPA met with Licensee Lorena Novoa (L1). It was alleged that a day care child sustained injuries while in care, specifically that a child had received a bruise on the head and shin while at the facility. It was also alleged that the Licensee did not notify day care child’s authorized representative of incidents.

LPA conducted an interview with L1 at 10:25am. Licensee stated that children climb and sometimes fall and they can be very active while in care, but that there was never a time that she recalls a child cried after falling and no bruises were observed after a fall. Licensee stated that if no injury was observed, it’s not her practice to notify the parents unless, the child cries a lot after a minor fall or bump, an injury is observed or medical attention is required. During the course of the investigation LPA interviewed L1's assistant at 11:25am and obtained records from L1.
Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
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 01-CC-20210714111458
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: NOVOA, LORENA FCCH
FACILITY NUMBER: 493008907
VISIT DATE: 07/23/2021
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
During today’s inspection the facility was toured at 11:10am. LPA observed the licensee and her assistant, Staff 1 (S1) providing care and supervision to eight children. LPA Strother observed the Licensee and S1 appropriately communicating with the children, conducting indoor playtime activities with the children; and staff supervising and promptly tending to the needs of the children in care.

Although a child may have sustained minor injuries while in care, LPA could not determine that the minor injuries were due to a lack of supervision or that a personal rights violation occurred resulting in the injury. If the Licensee or staff didn’t have knowledge that a child sustained an injury in care, she wouldn’t be able to report it to the child’s authorized representative.

Based on available information, there is not a preponderance of evidence to prove the allegations. The finding is determined to be unsubstantiated. This report was reviewed and discussed with the licensee. Appeal rights were provided. There were no Title 22 deficiencies cited during today’s inspection.

The Notice of Site Visit must be posted for 30 days.


SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2