<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426211932
Report Date: 03/30/2022
Date Signed: 03/30/2022 12:30:26 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, 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
01/14/2022 and conducted by Evaluator Sylvia Mendoza-Ceja
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20220114170200

FACILITY NAME:BERNAL FAMILY CHILD CAREFACILITY NUMBER:
426211932
ADMINISTRATOR:TOMASA BERNALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 562-8124
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:14CENSUS: 5DATE:
03/30/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Tomasa BernalTIME COMPLETED:
12:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee failed to report positive COVID exposures to CCLD
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) S. Mendoza-Ceja conducted an unannounced inspection to conclude the complaint. The complaint was initiated on January 21, 2022. The investigation included obtaining the child care roster, interviewing complainant, Licensees, and parents of children in care. In addition, reviewing Licensing databases which revealed Licensee did contact the Department on 01/28/2022.

Interviews with licensees revealed there was a positive COVID-19 case in the facility. The facility temporarily closed on 01/05/2022 - 01/12/2022 to ensure they did not spread the Covid-19 virus to the children and staff of the facility. Licensees stated they were not aware that they had to report the exposure to Community Care Licensing (CCL).

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
A Technical Violation was cited today.
No deficiencies were cited during today's visit. An exit interview was conducted.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2