Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153902874
Report Date: 06/11/2018
Date Signed 06/13/2018 09:52:16 AM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/10/2018 and conducted by Evaluator Jessika Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20180410091422
FACILITY NAME:SHELL, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
153902874
ADMINISTRATOR:SHELL, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 325-6488
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY:14CENSUS: 8DATE:
06/11/2018
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Leticia Shell, LicenseeTIME COMPLETED:
11:40 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee hits child in care.
Home smells of smoke.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessika Thompson arrived at facility to conduct an unannounced complaint visit to gather information to investigate the above mentioned allegations. LPA met with Licensee Leticia Shell, who accompanied LPA during tour of the facility. LPA explained the allegations, and a census was taken. During the course of this investigation, LPA interviewed witnesses, children, parents, and reviewed records.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies are cited during today's inspection.

An exit interview conducted with Licensee Leticia Shell was provided a copy of their appeal rights (LIC9058 12/15) and their signature on this form acknowledges receipt of this form.
A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.

Unsubstantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2018
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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