426212048-4-3-2024-17-CC-MMUR-D4DSXP-20240416141615

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 426212048
Report Date: 04/03/2024
Date Signed: 04/03/2024 11:01:23 AM

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
01/31/2024 and conducted by Evaluator Francisca Velazquez

COMPLAINT CONTROL NUMBER: 17-CC-20240131164034

FACILITY NAME:	AGUAYO FAMILY CHILD CARE		FACILITY NUMBER:	426212048
ADMINISTRATOR:	JOSEFINA AGUAYO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 925-8376
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 11	DATE:	04/03/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Josefina Aguayo		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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1.) Over capacity

INVESTIGATION FINDINGS:

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On 4/3/24, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced inspection of the Family Child Care Home (FCCH) to deliver the finding with respect to the allegation noted above. LPA met with Josefina Aguayo, Licensee of the FCCH and explained the nature and purpose of the investigation. LPA notes 11 children are present at the time of the inspection with Licensee and two (2) Assistants.

The investigation included two (2) unannounced site inspections, record review, and interviews with the Licensee, as well parents of children enrolled in the FCCH.

The allegation references facility is operating out of ratio/capacity. LPA was able to corroborate the allegation based on documents received during the investigation it was found that FCCH is operating over capacity, based on attendance registers which identify more than fourteen (14) children present in the FCCH at once for the month of November 2023. CONT: LIC9099C and LIC 9099D

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

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-20240131164034

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: AGUAYO FAMILY CHILD CARE	FACILITY NUMBER: 426212048
	VISIT DATE: 04/03/2024

NARRATIVE

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Based on LPA’s record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulation, (Title 22 Division 12 and 102416.5(d), is being cited on the attached LIC 9099 D).

A closing interview was conducted with Licensee, Josefina Aguayo. Licensee was provided and advised of Appeal Rights. A copy of this report was reviewed and provided to the Licensee. LPA explained the facility'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 and complete an LIC 9224 with copies maintained in each child's file. Every parent enrolling a new child in the facility shall receive a copy of the report and sign a LIC 9224 for the next twelve months. Licensee's signature at the bottom of this report acknowledges Licensee received the reports and understand their rights.

The Notice of Site Visit was also provided to the Licensee as required by H&S Code Section 1596.817. The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00 may apply.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC9099 (FAS) - (06/04)

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Control Number 17-CC-20240131164034

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: AGUAYO FAMILY CHILD CARE	FACILITY NUMBER: 426212048
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/03/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/04/2024 Section Cited CCR 102416.5	1 2 3 4 5 6 7	102416.5- Staffing Ratio and Capacity- (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee agrees to submit a written declaration detailing how Licensee will review the schedules of the families enrolled and make changes to make ensure that Licensee does not go over the capacity specified on the license by 4/4/24 via email at Francisca.Velazquez@dss.ca.gov
	8 9 10 11 12 13 14	Record review, specifically attendance registers submitted by licensee for payment revealed, licensee provided care for more than fourteen (14) children at a time during the months of November 2023. Specifically 11/1/23, 11/10/23 and 11/20-11/24, 2023.	8 9 10 11 12 13 14	This is an immediate risk to the health and safety of children in care.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC9099 (FAS) - (06/04)

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