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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020584
Report Date: 04/29/2022
Date Signed: 04/29/2022 04:19:17 PM

Unsubstantiated


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
03/14/2022 and conducted by Evaluator Cynthia Reyes
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20220314112724
FACILITY NAME:HERNANDEZ GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
198020584
ADMINISTRATOR:BESSIE HERNANDEZ GUZMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 462-1664
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY:14CENSUS: 6DATE:
04/29/2022
UNANNOUNCEDTIME BEGAN:
03:01 PM
MET WITH:Bessie Hernandez GuzmanTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Licensee not present in the home
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPAs) Cynthia Reyes and Carolyn Tuba, conducted an unannounced follow up inspection to present the findings of the complaint investigation. LPAs met with Bessie Hernandez Guzman, Licensee. A Covid-19 risk assessment was conducted prior to entering the facility. LPAs were guided to the day care room where 6 children, licensee assistant daughter Cynthia and other assistant Zoila was observed. Census and names, of the children were taken.

During the course of this investigation LPA Reyes and Tuba conducted interviews with Licensee, staff, children, reporting party (RP) and other witnesses. It was stated that the licensee is in the day care during the days and hours, and she does have two assistants to help her. Licensee also has outside employeement on the weekends doing real estate work. Other interviews states they do not see the licensee in the day care home when pick up and dropp off of their chidren are being conducted. Reporting party states they have not gone into the facility because of COVID and are not aware if the licensee or assistants are present when children are dropped off or picked up.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
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 33-CC-20220314112724
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: HERNANDEZ GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 198020584
VISIT DATE: 04/29/2022
NARRATIVE
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Reporting party states they have dropped off their child more than 3 times with a male adult at the front door who took the children in to the day care. LPAs observed and verified the adult males who are in the home are fingerprint cleared.

Although the allegation(s) may have happened or are valid there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Bessie Hernandez Guzman.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3