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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376626572
Report Date: 12/31/2020
Date Signed: 12/31/2020 05:01:55 PM



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
12/23/2020 and conducted by Evaluator Luigi Gargaro
COMPLAINT CONTROL NUMBER: 20-CC-20201223134603
FACILITY NAME:GARDNER, ERIN FAMILY CHILD CAREFACILITY NUMBER:
376626572
ADMINISTRATOR:ERIN GARDNERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 581-6210
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:14CENSUS: 0DATE:
12/31/2020
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Erin GardnerTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Licensee did not report suspected child abuse or neglect in a timely manner
INVESTIGATION FINDINGS:
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LPA, Luigi Gargaro, conducted an unannounced complaint tele-visit with the licensee today, due to the Covid-19 outbreak, regarding the above allegation. The facility was closed today but licensee spoke to analyst about the allegation.

During today's visit, analyst discussed allegation that licensee failed to report a suspected child abuse incident after child #1 disclosed to her that inappropriate physical contact occurred in her home and caused her physical injury. Licensee advised analyst that she did not submit a report to licensing in error, as she was not aware that she had to, but, with review of reporting requirements during today's visit, understands her reporting obligations and will ensure meeting them going forward.

Based on LPA's observations, record review(s) and interviews that were conducted, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED, California Code of Regulations, (Title 22, Division & 102416.2(c)(1)) is being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion: 30
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 12/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/31/2020
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-20201223134603
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: GARDNER, ERIN FAMILY CHILD CARE
FACILITY NUMBER: 376626572
VISIT DATE: 12/31/2020
NARRATIVE
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A copy of the report and appeal rights will be e-mailed to the licensee and she was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 12/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/31/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 20-CC-20201223134603
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: GARDNER, ERIN FAMILY CHILD CARE
FACILITY NUMBER: 376626572
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/31/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/04/2021
Section Cited
CCR
102416.2(c)(1)
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Reporting Requirements. In addition to the events specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C), the licensee shall report the following events to the Department: 1) Any suspected child abuse or neglect...This requirement was not met as evidenced by: based on interviews and record reviews,
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The licensee has until 01/04/21 within which to complete and submit a required written unusual incident report to analyst to correct the deficiency. Licensee also understands that all future incidents must be reported to the Department verbally within 24 hours and in written form within seven days.
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licensee failed to submit a written or verbal unusual incident report to the Department after child #1 reported a case of inappropriate physical contact occurring in her home to the provider on 12/10/20. Not meeting Licensing reporting requirements is a potential danger to 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.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 12/31/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/31/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3