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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334842800
Report Date: 02/13/2023
Date Signed: 02/13/2023 09:56:16 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/29/2022 and conducted by Evaluator Justin Giese
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220829113831
FACILITY NAME:GUIRGUIS FAMILY CHILD CAREFACILITY NUMBER:
334842800
ADMINISTRATOR:GUIRGUIS,INASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 797-6888
CITY:CORONASTATE: CAZIP CODE:
92883
CAPACITY:14CENSUS: 3DATE:
02/13/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Inas GuirhuisTIME COMPLETED:
10:05 AM
ALLEGATION(S):
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Children engaged in inappropriate behavior due to lack of supervision
INVESTIGATION FINDINGS:
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On 02/13/2023 at time listed above Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for the purpose of concluding a complaint investigation. LPA met with Licensee, Inas Guirguis, regarding the above allegation, which was received on 08/29/2022.

It was alleged children engaged in inappropriate behavior due to lack of supervision. The complaint investigation was referred and accepted by Community Care Licensing (CCL) Investigations Bureau (IB) on 08/29/2022. The complaint was investigated by IB Investigator M. Williams. LPA Giese conducted an unannounced visit to the facility on 09/01/2022 for the purpose of initiating the complaint investigation.
At time of visit, LPA Giese made contact with a facility representative, conducted interviews, and reviewed/collected facility records and supporting documentation. All Information and documentation collected by LPA was forwarded to CCL IB.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023
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 09-CC-20220829113831
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: GUIRGUIS FAMILY CHILD CARE
FACILITY NUMBER: 334842800
VISIT DATE: 02/13/2023
NARRATIVE
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In addition to CCL IB’s independent investigation of the allegation, local law enforcement conducted an investigation as well. CCL IB determined the documents collected, records reviewed, and statements made by pertinent parties do not prove or disprove the allegation.

This agency has investigated the complaint alleging children engaged in inappropriate behavior due to lack of supervision. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS GIVEN. LICENSEE WAS INSTRUCTED TO POSTED IT IN A PROMINENT LOCATION AT THE FACILITY. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

An exit interview was conducted, A copy of this report and appeal rights were given to the Licensee during this inspection on 02/13/2023.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2