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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 421710081
Report Date: 12/17/2020
Date Signed: 12/17/2020 02:22:06 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
10/15/2020 and conducted by Evaluator Austin Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20201015103108
FACILITY NAME:BURNS FCC AKA SUNSHINE DAY CAREFACILITY NUMBER:
421710081
ADMINISTRATOR:BURNS, NAOKOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 735-3904
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 3DATE:
12/17/2020
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Naoko BurnsTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Level of care- Day care child not adequately being supervised resulting in injuries
INVESTIGATION FINDINGS:
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On December 17, 2020 at pm, Licensing Program Analyst (LPA) Austin Rios conducted an unannounced tele-video inspection via Facetime due to COVID-19 State of Emergency to conclude the investigation of the above allegation. LPA Rios met with licensee Naoko Burns and licensee assistant Rebecca Renn. LPA Rios explained the purpose of the inspection. Licensee and LPA Rios conducted a virtual tour of the home. There were three children present.

The allegation is that day care child not adequately being supervised resulting in injuries. Investigation included interviewing complainant, licensee, current staff assistant, prior staff assistant, parents of children in care and obtaining the child care roster. Licensee denies the allegation. None of the staff or parents interviews corroborated the allegation.Parents indicated they are satisfied with the care and supervision. Although this allegation may have occurred, there is not a preponderance of evidence to prove that the alleged violations did or did not occur, therefore, the allegation listed above is deemed UNSUBSTANTIATED.

CONTINUED ON LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2020
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-20201015103108
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: BURNS FCC AKA SUNSHINE DAY CARE
FACILITY NUMBER: 421710081
VISIT DATE: 12/17/2020
NARRATIVE
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Exit interview was conducted with Naoko Burns, via tele-inspection. This report will be sent to the licensee via email with a read receipt or confirmation of receipt of email, which will act as the licensee signature. The Notice of Site Visit (LIC9213) will also be e-mailed to the licensee. The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2020
LIC9099 (FAS) - (06/04)
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