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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 406215801
Report Date: 03/28/2022
Date Signed: 03/28/2022 10:56:26 AM

Unsubstantiated


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
01/31/2022 and conducted by Evaluator Francisco Pedroza
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20220131105352
FACILITY NAME:GUTIERREZ FAMILY CHILD CARE AKA KIDZ KLUBHOUSEFACILITY NUMBER:
406215801
ADMINISTRATOR:MICHAEL RICHARDO GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 835-3741
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:14CENSUS: 4DATE:
03/28/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michael GutierrezTIME COMPLETED:
11:05 AM
ALLEGATION(S):
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Personal Rights
Lack of Care and Supervision
INVESTIGATION FINDINGS:
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On March 28, 2021 at 10:05 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced inspection to conclude a complaint investigation. LPA met with Licensee Michael Gutierrez and advised him the purpose of the inspection. Licensee provided LPA a tour of the home. There were four (4) children in the home at the time of the inspection.

Allegation(s) stated the licensee was not providing supervision for children and children were playing in the street. LPA conducted two unannounced inspections touring the facility inside and out during each inspection. During the course of the investigation, LPA conducted parent interviews, neighbor interviews, and an interview with licensee. Licensee, neighbors, and parent interviews did not provide evidence to collaborate with the allegation(s). Licensee denied the allegation(s) during the interview. Licensee advised that periodically he may have one (1) to three (3) children outside in front yard with him.

Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022
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 2
Control Number 17-CC-20220131105352
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 FAMILY CHILD CARE AKA KIDZ KLUBHOUSE
FACILITY NUMBER: 406215801
VISIT DATE: 03/28/2022
NARRATIVE
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He would only do that when when a parent contacts him advising that they are coming to pick up their children. Licensee advised he only does this when the parent informs him they are coming and he only has a couple of children present. Licensee advised that he is outside with the children and they are only playing on the front yard. The children do not go on the sidewalk or near the street.

Interviews with parents and neighbors did not collaborate with them observing children unsupervised in the front of the home or playing in the street. Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2