Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 192002652
Report Date: 06/10/2016
Date Signed 06/10/2016 02:16:45 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/29/2016 and conducted by Evaluator Karen Chambers
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20160229164519
FACILITY NAME:TORRES FAMILY CHILD CAREFACILITY NUMBER:
192002652
ADMINISTRATOR:ROSA TORRESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 404-5219
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 10DATE:
06/10/2016
UNANNOUNCEDTIME BEGAN:
11:34 AM
MET WITH:Claudia SalazarTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Personal Rights - Child sustained unexplained injury
INVESTIGATION FINDINGS:
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Upon the arrival of this LPA, the Licensee was not present, as she was out picking up a day-care child.

During the course of the investigation conducted by Complaint Specialist-LPA, Karen Chambers, interviews were conducted with the complainant, potential adult witness, the Licensee, assistants as well as day-care children.

During the interview with a potential witness, the bump and bruise was observed on child #1 while at the day-care, but they did not mention or say anything to the Licensee. Pictures of the injury were taken and sent to the parent of child #1.

According to the parent of child #1, they noticed the bump and bruise later that evening when they arrived home. That a phone call was made to the Licensee on Monday to find out what happened. Parent of child #1 also indicated that they went to the Police and completed an affidavit (there was no record of this found). Parent of child #1 also indicated during the interview that medical attention was not sought as they felt it wasn't needed.
Inconclusive
Estimated Days of Completion:
SUPERVISOR'S NAME: Bertha ManzanaresTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Karen ChambersTELEPHONE: (323)854-7636
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2016
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 33-CC-20160229164519
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 192002652
VISIT DATE: 06/10/2016
NARRATIVE
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According to the Licensee, child #1 did not sustain any injury while in her care. She also mentioned that she was told by the parent of child #1, that if child #1 did sustain any type of injury that she (Licensee) would need to complete an incident report for the parent to show their Social Worker. The Licensee's assistants also confirmed this information during their interviews.

During the interviews with the day-care children there were no disclosures made.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the above allegation is inconclusive at this time.

The notice of site visit was posted where the parent/guardian of children enter and exit the facility. This notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with the Licensee, during which appeal rights were explained. A copy of the appeal rights (LIC9058 01/16 were provided. The Licensee’s signature on this reports acknowledges receipt of her rights.
SUPERVISOR'S NAME: Bertha ManzanaresTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Karen ChambersTELEPHONE: (323)854-7636
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2016
LIC9099 (FAS) - (06/04)
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