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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376611874
Report Date: 03/01/2022
Date Signed: 03/01/2022 10:30:19 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/06/2022 and conducted by Evaluator Rajani Goudreau
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20220106164549
FACILITY NAME:GURMILAN, ROSA FAMILY CHILD CAREFACILITY NUMBER:
376611874
ADMINISTRATOR:GURMILAN, ROSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 428-8942
CITY:SAN YSIDROSTATE: CAZIP CODE:
92173
CAPACITY:14CENSUS: 4DATE:
03/01/2022
UNANNOUNCEDTIME BEGAN:
08:31 AM
MET WITH:Rosa Gurmilan TIME COMPLETED:
09:03 AM
ALLEGATION(S):
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Day care child wandered from facility while in care.
INVESTIGATION FINDINGS:
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On 03/01/22 at 8:31 a.m., Licensing program Analyst (LPA) Rajani Goudreau conducted an unannounced complaint visit for the purpose of delivering the complaint finding to the above listed allegation. Upon arrival LPA met with licensee, Rosa Gurmilan, and proceeded to tour the facility. During the visit there were four children in care with one staff member present. In addition, licensees’ spouse was present in the home. During the course of the investigation, LPA obtained and reviewed facility and outside agency records pertaining to the incident. Interviews were conducted with licensee, licensees’ spouse, staff member, day care parents, and witnesses.

On January 06, 2022, Community Care Licensing (CCL) received a complaint alleging a day care child wandered from the facility while in care. During an interview with licensee, licensee disclosed on January 06, 2022 around 4:00 p.m., child #1 (C1) left the front yard unsupervised during outdoor play. Based on licensees admission, interviews with staff member, licensees’ spouse, witnesses #1 & #2 and documentation received from an outside agency, C1 left the facility unsupervised for an estimate of 2 to 10 minutes and was found on the corner of Blando Court and Blando Lane by witnesses #1 and #2, approximately 118 feet from the daycare facility. See LIC9099-C continuation page...
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
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 20-CC-20220106164549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GURMILAN, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376611874
VISIT DATE: 03/01/2022
NARRATIVE
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The preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. California Code of Regulations, (Title 22, Division 12 & Chapter 3, is being cited on the attached LIC 9099D and an immediate civil penalty of five hundred dollars ($500), is being assessed on the attached LIC 421IM, H&S section 1597.58(c)(2).

LPA, Rajani Goudreau, informed licensee that this report dated 03/01/22 documents a type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

LPA, Rajani Goudreau, also informed the licensee to provide a copy of this licensing report dated 03/01/22 that documents the Type A citation 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. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee, Rosa Gurmilan.

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 20-CC-20220106164549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GURMILAN, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376611874
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/02/2022
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 stated, she fixed the gate to ensure the latch is placed higher on the fence, added a spring on the gate to ensure the gate automatically closes and latches when closed. Licensee stated she will watch the following video titled: Supervising Children in Family Child Care
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Based on licensee’s admission, interviews conducted, and records reviewed the licensee did not ensure a daycare child was supervised at all times, as C1 left the front yard unsupervised, which poses an immediate Health and Safety risk to children in care.

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at ccld.childcarevideos.org/family-child-care-providers/supervising-children-in-family-child-care and provide a summary of the video. Licensee will submit a written plan to ensure the children are supervised at all times during outdoor activities. Plan of corrections due by: 03/02/22. A Non-compliance conference will be scheduled; date and time to be determined.
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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.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3