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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503608712
Report Date: 11/01/2022
Date Signed: 11/01/2022 02:34:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/05/2022 and conducted by Evaluator Priscilla Zamudio
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20220805090851

FACILITY NAME:VIGIL, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
503608712
ADMINISTRATOR:VIGIL, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 872-2820
CITY:MODESTOSTATE: CAZIP CODE:
95358
CAPACITY:14CENSUS: 0DATE:
11/01/2022
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Leticia VigilTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Adult male in home kissed day care child
INVESTIGATION FINDINGS:
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On 11/1/22, Licensing Program Analyst (LPA) Priscilla Zamudio conducted an unannounced complaint visit to provide finding to the above allegation. LPA met with Licensee, Leticia Vigil, toured the facility and there were no children present.

During the course of the investigation, LPA conducted interviews and reviewed pertinent documentation.
Based upon information gathered through interviews, the preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, this deficiency is being cited on the attached LIC 9099-D.

An exit interview conducted with Licensee Leticia Vigil. A copy of this report and Appeal Rights were provided and discussed with Licensee.

A Notice of Site Visit Form was provided to Licensee and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
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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Control Number 04-CC-20220805090851
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VIGIL, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 503608712
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2022
Section Cited
CCR
102423(a)(1)
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Personal Rights
(a)The licensee shall ensure that each child is accorded the following personal rights: (1)To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:
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Per Licensee, the adult male will watch a video about children's personal rights and provide a written statement on how to comply. It will be submitted to licensing by 11/8/22.
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Based on interviews, an adult male in the home kissed day care child. This is a potential risk of personal rights, health and safety to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3