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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 543910105
Report Date: 10/11/2021
Date Signed: 10/11/2021 11:32:44 AM

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
07/26/2021 and conducted by Evaluator Ruby Ocegueda
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20210726132810
FACILITY NAME:DIAZ, CLEMENTINA FAMILY CHILD CAREFACILITY NUMBER:
543910105
ADMINISTRATOR:DIAZ, CLEMENTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 232-4255
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY:14CENSUS: 6DATE:
10/11/2021
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Diaz, ClementinaTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegations related to Personal Rights:
Licensee handled day-care child in a rough manner.

Adult in home uses profanity towards day-care children.

Adult in home pulled day-care child's hair.

Licensee used inappropriate form of discipline.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/11/2021, Licensing Program Analyst (LPA) Ocegueda conducted an unannounced complaint inspection for the purposes of delivering the findings for the above named allegations. LPA met with licensee Clementina Diaz, toured the facility and took a census.

During the course of the investigation, LPA Ocegueda conducted interviews of Licensee, staff, children, day care parents and complainant and gathered facility records. LPA gathered evidence that included corroborating statements from individuals interviewed who indicated that licensee used inappropriate discipline practices, used profanity while caring for children and handled children inappropriately. In addition, on 7/28/2021, during an on-site inspection, LPA Ocegueda and LPA Galvan also observed licensee using profanity, displayed yelling in her interactions with LPA’s and made several inappropriate sarcastic comments about abusing children all while children were in care that day. These observations were addressed with licensee and she confirmed LPA’s observations in regard to her behavior. The information gathered during the investigation indicate that licensee has violated the personal rights of children in care.
Report to 9099-C

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
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 3
Control Number 04-CC-20210726132810
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: DIAZ, CLEMENTINA FAMILY CHILD CARE
FACILITY NUMBER: 543910105
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/12/2021
Section Cited
CCR
102423(4)
1
2
3
4
5
6
7
To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature...this requirement was not met as evidencend by: interviews. LPA discovered via multiple corroborating interviews that
1
2
3
4
5
6
7
Licensee stated she would submit the following to show she will ensure the personal rights of children in care by submitting a written plan indicating understanding of personal rights requirements and updated policies for her facility by POC date: 10/12/2021.
8
9
10
11
12
13
14
licensee and or staff participated in hair pulling, inappropriate discipline, use of profanity, and mishandling of children in care which is a violation of Personal Rights. This poses an immediate risk to the health, safety and or personal rights of children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 04-CC-20210726132810
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: DIAZ, CLEMENTINA FAMILY CHILD CARE
FACILITY NUMBER: 543910105
VISIT DATE: 10/11/2021
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
This agency has investigated the complaint allegations stating that Licensee handled day-care child in a rough manner, adult in home uses profanity towards day-care children, Licensee used inappropriate form of discipline, found that the complaint was SUBSTANTIATED, meaning the preponderance of evidence standard has been met.

Per California Code of Regulation, Title 22, Division 12, Chapter 3, the following deficiency was cited (see LIC 9099-D).

An Exit interview was conducted with Licensee, Clementina Diaz. A copy of this report and appeal rights were provided to Licensee. LPA also reviewed “Acknowledgment of Receipt of Licensing Form” (LIC 9224). Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Licensee understands that she is to sign report 9099 and 9099 D and mail back to Community Care Licensing office.

A copy of this report shall be posted for 30 days.
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3