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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334845737
Report Date: 03/20/2024
Date Signed: 03/20/2024 03:45:49 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/13/2024 and conducted by Evaluator Lorena Valenzuela
COMPLAINT CONTROL NUMBER: 10-CC-20240313103622
FACILITY NAME:MEDINA FAMILY CHILD CAREFACILITY NUMBER:
334845737
ADMINISTRATOR:MEDINA,YARAVIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 910-0142
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY:14CENSUS: 5DATE:
03/20/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Yaravi MedinaTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Licensee does not ensure children are provided with adequate care and supervision at all times
INVESTIGATION FINDINGS:
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On March 20, 2024, at 12:30PM, Licensing Program Analyst (LPA) Lorena Valenzuela conducted an unannounced complaint inspection at Medina Family Child Care home and met with Licensee, Yaravi Medina. The purpose of the inspection was to initiate an investigation and to deliver the findings on the above stated allegation. During this inspection, LPA's toured facility, took census, and interviewed the Licensee and Assistant 1 (A1). In addition, LPA's collected copies of pertinent facility documents. Additionally, as part of the investigation, LPA Valenzuela conducted an interview with other relevant parties.
On March 13, 2024, Community Care Licensing (CCL) received information licensee does not ensure children are provided with adequate care and supervision at all times. It was reported on 03/12/2024, C1’s authorized representative arrived at the day care home to pick up Child #1 (C1) and C1 was not found to be at the day care home. Interviews corroborated on 03/12/2024, C1 was picked up from school by licensee between 2:30pm to 2:45pm and taken to the daycare home, arriving at the daycare home at approximately 3:05pm.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
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 10-CC-20240313103622
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MEDINA FAMILY CHILD CARE
FACILITY NUMBER: 334845737
VISIT DATE: 03/20/2024
NARRATIVE
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Interviews revealed that at approximately 3:35pm licensee stepped outside of the daycare areas of the home, and it was at this time that licensee last saw C1 in the backyard of the daycare home. Interviews revealed Assistant 1 was inside the home with other day care children but was not made aware C1 was in the backyard (unattended). Interviewed revealed C1’s authorized representative arrived to pick C1 at 4:30pm, and asked licensee and assistant 1 where C1 was, however, after looking for C1 in all areas of the day care home, C1 was not found. Confidential interviews revealed C1 was found in a nearby street unattended and C1 was returned to the facility by law enforcement.
Based on interviews and records review, the preponderance of evidence standard has been met, and the allegation the licensee does not ensure children are provided with adequate care and supervision at all times, is substantiated. The facility is being cited under Title 22, Section 102417 (a) Operation of a Family Child Care Home. See deficiency report, LIC 9099D for citation cited. A civil penalty was also issued.

LPA Lorena Valenzuela informed licensee Yaravi Medina that this report dated 03/20/2024 document(s) (1 Type A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Lorena Valenzuela informed the licensee to provide a copy of this licensing report dated (03/20/2024) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit interview was conducted, and a copy of this report, LIC 9099-D, LIC 421IM, and appeal rights was provided to the Licensee Yaravi Medina. A Notice of Site Visit was issued and posted.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20240313103622
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MEDINA FAMILY CHILD CARE
FACILITY NUMBER: 334845737
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/21/2024
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home (a)The licensee shall be present in the home and shall ensure that children in care are supervised at all times...
This requirement was not met as evidenced by:
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Licensee states will submit a written statement detailing a supervision plan and actions to be taken to ensure children in care are under care and supervision at all times. Will submit to the Department by due date 03/21/2024.
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Based on interviews and records review, the licensee did not ensure C1 was under care and supervision on 03/12/2024, wherein C1 was found by law enforcement unattended outside the day care home in a nearby street. This poses, an immediate risk to the, health, safety and personal rights of 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: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC9099 (FAS) - (06/04)
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