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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 553623119
Report Date: 01/23/2023
Date Signed: 01/23/2023 11:51:07 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/18/2022 and conducted by Evaluator Tiffanie Diep
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20221118120714
FACILITY NAME:VACA, DEBBIEFACILITY NUMBER:
553623119
ADMINISTRATOR:DEBBIE VACAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 532-0899
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY:14CENSUS: 7DATE:
01/23/2023
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Debbie VacaTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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9
Personal Rights - Day care child sustained bruising while in care
Ratio - Day care home is out of ratio
INVESTIGATION FINDINGS:
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On 01/23/2023 at 11:15 AM, Licensing Program Analysts (LPAs) Tiffanie Diep and Lauren Scott met with Licensee, Debbie Vaca, to conduct an unannounced visit to deliver the findings of a complaint investigation regarding the above allegations. There were three staff present supervising seven children.

It was alleged that a day care child sustained bruising while in care. It was also alleged that the day care home is out of ratio. During the course of the investigation, LPA made observations at the facility and obtained relevant documents. LPA conducted interviews with the reporting party, Licensee, staff, day care children, and multiple parents. Interviews conducted revealed that other adults in the home who have criminal record clearances are present at the facility and provide assistance to Licensee when there are more than eight children in care at one time. Information obtained did not reveal sufficient information that was evident to support the allegations that a day care child sustained bruising while in care and that the day care home is out of ratio.
Continues on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023
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 53-CC-20221118120714
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: VACA, DEBBIE
FACILITY NUMBER: 553623119
VISIT DATE: 01/23/2023
NARRATIVE
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Based on the information obtained throughout the course of the investigation, the above allegations could not be substantiated or dismissed. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted and report was reviewed with the licensee, Debbie Vaca. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2