406214951-6-24-2021-17-CC-MMUR-C5YPY6-20210817114318

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 406214951
Report Date: 06/24/2021
Date Signed: 06/24/2021 05:59:56 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/24/2021 and conducted by Evaluator Gigi Reyes

PUBLIC

COMPLAINT CONTROL NUMBER: 17-CC-20210624152317

FACILITY NAME:	GUTIERREZ FCC AKA KIDZ CARE		FACILITY NUMBER:	406214951
ADMINISTRATOR:	MARTHA GUTIERREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 221-5534
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	14	CENSUS: 1	DATE:	06/24/2021
		UNANNOUNCED	TIME BEGAN:	05:04 PM
MET WITH:	Martha Gutierrez		TIME COMPLETED:	06:00 PM

ALLEGATION(S):

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Lack of supervision resulting in day care child wandering from the facility

INVESTIGATION FINDINGS:

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On 6/24/2021 at 5:04 PM, Licensing Program Analysts (LPAs) Gigi Reyes and Martina Jimenez conducted an unannounced inspection at Gutierrez Family Child Care Home to conclude the complaint investigation on the above allegation. LPAs met with Martha Gutierrez, Licensee. LPAs advised the Licensee of nature and purpose of the inspection to conclude the complaint investigation. Prior to entering the FCCH, LPA asked Licensee Pre Screening questions related to COVID-19. Licensee's responses suggest no COVID exposure on site.

Community Care Licensing Division (CCLD) received complaint control no. 17-CC-20210624152317 on 6/24/2021 regarding the above allegations. On 6/23/2021, Licensee self reported Child # 1 wandered away from Family Child Care Home with out the knowledge of Licensee or Assistant.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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 17-CC-20210624152317

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE	FACILITY NUMBER: 406214951
	VISIT DATE: 06/24/2021

NARRATIVE

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On 6/23/2021, at or about 1:20 PM during nap time, a 26 month old child (herein referred to as Child #1) walked out the door, left FCCH without the knowledge of Staff # 1 who was supervising the 11 napping children. Staff 2 was on the other room watching two infants.

Based on the interview conducted with Licensee and Staff #1, Staff #1 thought that all 11 children were sleeping, Staff #1 proceeded to the kitchen and washed dishes, at that point Child 1 exited the front door unnoticed by Staff 1 and Staff # 2. Staff #1 stated it took 10 minutes before Staff # 1 realized Child # 1 was missing as opposed to statement of Staff #2 that it took about 30 minutes. Licensee stated that during the time of the incident, Licensee went to Community Health Clinic (CHC ) to get TB Test.

On 6/24/2021, LPAs traveled along the street where Child # 1 was found - Montebello Oaks Drive a street perpendicular to Kleck Road where FCCH physical address is located.

Based on LPAs measurement, Child #1 walked along a street sidewalk an estimated 1512 feet more or less from the FCCH unsupervised by Licensee or Assistant for about 31 minutes. Child was walking barefoot under 83 degree Fahrenheit weather.

LPAs interviewed Adult #1 who observed the child in front of their home walking along the bike lane. Adult #1 stepped out of Adult #1's home and followed along Child # 1, observing if Child #1 had adult companion. After another 455 feet, Adult # 1 decided to talk to Child #1 when Adult #1 determined Child # 1 was unaccompanied. Child# 1 crossed 2 streets with moving vehicles running 35 to 40 miles an hour (25 mph). Adult #1 contacted Paso Robles Police Department( PRPD) and PRPD returned Child # 1 to Family Child Care Home.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC9099 (FAS) - (06/04)

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Control Number 17-CC-20210624152317

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE	FACILITY NUMBER: 406214951
	VISIT DATE: 06/24/2021

NARRATIVE

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Investigation was conducted today, which includes Interview with Licensee, Staff # 1, Staff # 2, Day Care children, neighbors. LPAs obtained report from Paso Robles Police Department (PRPD), Call For Service Event # 2106230073

Based on LPAs observation, interviews conducted and reports gathered, the preponderance of evidence standard was met, therefore the above allegation is SUBSTANTIATED
Deficiencies were cited per California Code of Regulations Title 22 Division 12 Chapter no. 102432 (a)(2) and 102417(a) under Case Management Report dated 6/24/2021(See LIC 809, LIC 809C and LIC 809D)

An exit interview was conducted with Licensee. Appeal Rights were given and explained to the Licensee. LPA discussed and explained the FCCH's required plan of correction.

Licensee was provided the Acknowledgement of Receipt (LIC 9224). Parents shall receive a copy of 9099, 9099C, and 9099D. Each parent/guardian shall sign an LIC 9224 with copies maintained in each child's file. Every parent enrolling a new child in the FCCH shall receive a copy of the report and sign a LIC 9224 for the next twelve months. A copy of this report was reviewed and provided to the Licensee.

LPAs observed Licensee posted Notice of Site (LIC 9213) visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC9099 (FAS) - (06/04)

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