406215266-10-15-2021-17-CC-MMUR-C85VJC-20211025162831

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 406215266
Report Date: 10/15/2021
Date Signed: 10/15/2021 04:07:34 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
09/01/2021 and conducted by Evaluator Elvin Baddley

COMPLAINT CONTROL NUMBER: 17-CC-20210901091556

FACILITY NAME:	COUNTRY COTTAGE PRESCHOOL		FACILITY NUMBER:	406215266
ADMINISTRATOR:	BRIANNA MALLORY		FACILITY TYPE:	850
ADDRESS:	2075 JOHNSON AVENUE		TELEPHONE:	(805) 235-2153
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	62	CENSUS:	DATE:	10/15/2021
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Kimberly Barrientos		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility is not enforcing mask requirement.

INVESTIGATION FINDINGS:

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On 10/15/21, at 3:00 PM, Licensing Program Analyst (LPA) Elvin Baddley made an unannounced inspection to the abovementioned Child Care Center (CCC) to deliver a finding with regard an investigation related to the CCC not enforcing mask requirement.. LPA met with Kimberly Barrientos, the CCC's Assistant Director, and explained the purpose of the inspection. LPA, in the company of the Assistant Director toured the interior and exterior of the CCC. LPA observed 24 children in care at the time of the inspection, along with six teacher providing care and supervision.

The investigation included record reviews as well as interviews of the Adminstrator, a sampling of staff, children and parents of children in care.

Interviews revealed the CCC informed parents of children in care of the requirment for children to wear face covering inside of the CCC. The information was convey to parents just days after the local Health
(CONT. 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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-20210901091556

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: COUNTRY COTTAGE PRESCHOOL	FACILITY NUMBER: 406215266
	VISIT DATE: 10/15/2021

NARRATIVE

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Department (San Luis Obispo) implemented the requirement of wear facing covering inside of businesses. Parents, staff and children noted CCC staff do encourage and direct the children to wear face coverings when inside the CCC. Staff and Parent interviewed suggest although children are directed and encourage to wear face coverings, children may simply take their face covering off following encouragement, directions and redirection. As the staff members to do force any children to wear face covering, children are sometimes observed on site without face coverings with acceptable reason.

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

A LIC 9213 (Notice of Site Visit) form was provided and posted at the conclusion of the inspection.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

LIC9099 (FAS) - (06/04)

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