376628570-4-18-2022-20-CC-TVUU-CE4RYC-20220504132603

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376628570
Report Date: 04/18/2022
Date Signed: 04/18/2022 12:52:29 PM

Substantiated

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
03/21/2022 and conducted by Evaluator JoAnn R Legaspi

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20220321114547

FACILITY NAME:	MARTINEZ, ELVIA FAMILY CHILD CARE		FACILITY NUMBER:	376628570
ADMINISTRATOR:	ELVIA MARTINEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 653-9129
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY:	14	CENSUS: 3	DATE:	04/18/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Elvia Martinez		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Lack of supervision resulting in a day care child leaving the facility

INVESTIGATION FINDINGS:

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On 04/18/2022 at 9 AM, Licensing program Analyst (LPA) Jo Ann Legaspi conducted an unannounced a complaint inspection to deliver the findings to the above allegation. LPA advised Licensee Elvia Martinez of the inspection’s purpose; she granted LPA facility entry. Present in the home was the Licensee, Staff Elena Aguirre, two (2) daycare toddlers and one (1) school aged daycare child. Language Link Operator 13629 provided Spanish translation services.

The investigation involved a facility tour, document reviews and observation of the daycare camera videos. It also involved interviews with involved witnesses, daycare parents, the Licensee and Staff 1. (See LIC 811 Confidential Names).

On 03/18/2022, at about 1:40 PM, Child 1 was found without adult supervision wandering on a busy street about 0.2 miles from the daycare. Two (2) witnesses found the unsupervised child and contacted law

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

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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Control Number 20-CC-20220321114547

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: MARTINEZ, ELVIA FAMILY CHILD CARE	FACILITY NUMBER: 376628570
	VISIT DATE: 04/18/2022

NARRATIVE

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This is an amended version of the report that was created on 04/18/2022.

enforcement. Law enforcement returned C1 to the daycare between 2:51 – 2:59 PM. Both the Licensee and S1 report that during the incident S1 was left alone with eleven (11) daycare children while the Licensee was gone conducting child transportations. S1 stated they were unaware C1 left the daycare until law enforcement returned C1 to the daycare.

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 for the absence of supervision on the attached LIC 421IM, H&S section 1597.58(c)(2).

LPA Legaspi informed Licensee that this report dated 04/18/2022 documents a type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, and personal rights of children in care.

LPA Legaspi also informed the Licensee to provide a copy of this licensing report dated 04/18/2022 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 each child's file for verification. LPA provided Licensee with a blank LIC 9224 form.

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 Elvia Martinez.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC9099 (FAS) - (06/04)

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Control Number 20-CC-20220321114547

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: MARTINEZ, ELVIA FAMILY CHILD CARE	FACILITY NUMBER: 376628570
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/18/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/29/2022 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	Operation of a Family Child Care Home - " ... The licensee shall ... ensure that children in care are supervised at all times… This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee states she has installed a chain guard on the street daycare gate and now physically meets parents at the gate to perform child exchanges. Licensee was given a hard copy of CCR 102417(a). Licensee has watched the CCLD training video titled “Supervising Children in Family Child Care”. Licensee
	8 9 10 11 12 13 14	Based on video observations, record reviews, interviews with Licensee, S1 and involved witnesses, Licensee did not ensure children in care were supervised, which poses an immediate risk to the health and safety children in care.	8 9 10 11 12 13 14	agrees to provide the Department with a written summary of her observations of the above training video and a written plan describing how she will ensure all children are always supervised by adult daycare staff no later than 04/29/2022.
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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 Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

LIC9099 (FAS) - (06/04)

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