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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426215387
Report Date: 09/20/2023
Date Signed: 09/20/2023 03:58:26 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
09/15/2023 and conducted by Evaluator Martina Jimenez
COMPLAINT CONTROL NUMBER: 17-CC-20230915122639
FACILITY NAME:HERRERA FCC AKA CHU CHU TRAIN DAYCAREFACILITY NUMBER:
426215387
ADMINISTRATOR:NORMA HERRERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 922-3282
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:14CENSUS: 4DATE:
09/20/2023
UNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Norma Herrera TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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1. Licensee does not ensure adequate supervision is provided to children in care
2. Licensee did not ensure reporting requirements were followed
3. Licensee does not ensure admissions policy if followed for children in care
INVESTIGATION FINDINGS:
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On 9/20/2023, at 9:05 AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced inspection of the Family Child Care Home (FCCH) to initiate a compliant investigation reference to the above allegations.

LPA met with Norma Herrera, licensee, and Ximena Ponce De Leon, assistant, who arrived at 11:00 AM, to the FCCH. LPA Jimenez explained the nature and purpose of the investigation. LPAs observed two (2) infants and one (1) child in care at the time of the inspection.

The investigation included one (1) unannounced inspections, LPAs observation, interview with licensee, review of children's files, and, documents obtained during the inspection.

CONT LIC 9099-C & LIC 9099D
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
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 4
Control Number 17-CC-20230915122639
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: HERRERA FCC AKA CHU CHU TRAIN DAYCARE
FACILITY NUMBER: 426215387
VISIT DATE: 09/20/2023
NARRATIVE
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The allegations references the licensee does not ensure adequate supervision is provided to children in care, licensee did not ensure reporting requirements were followed, and Licensee does not ensure admissions policy if followed for children in care.

On 8/29/2023, @ 4:30pm, licensee and assistant were sitting at the children's table in the day-care room, the children were laughing, and playing on their tummies, in the day-care room, on the carpet. C1 was walking around on the carpet where the children were on their tummies, when C1 approached C2 bitting C2 on the upper left shoulder, leaving a bite mark on the left shoulder, the licensee advised mother of the incident at time of pick. The licensee did not report the incident to CCLD.

On 9/6/2023, Licensee stated that C3 had an early day at school (leaving school at 12:30am). The licensee stated from the school the licensee and C3 went to Whispering Tree Nursery in Orcutt, to purchase two (2) bags of dirt. The licensee stated that she purchased the dirt and came directly to the FCCH. Licensee stated that licensee and C3 arrived to the FCCH around 1:00pm. Licensee stated C3 permission slip to take part in field trips by foot, car, or public transportation had been denied and parent had requested C3 just be transported to and from school.

On 9/14/23,@ 3:05pm, Licensee stated was she was out picking up day-care children from school, upon licensee's return to the FCCH, the assistant advised the licensee that C1 had attempted to bite C2 on the shoulder again. The licensee removed C2 shirt and observe a mark on the right upper arm. Licensee did not notify the Mother of the incident nor did licensee notify CCLD within 24 hours of the incident.

Based on LPA’s observation, interview with licensee, record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

The inspection visit was conducted in Spanish and report was translated in Spanish by LPA Jimenez. Today, deficiency cited under Title 22 Division 12, Appeal rights provided to licensee. LPA provided the Licensee a Notice of Site (LIC 9213),LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY. This REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 17-CC-20230915122639
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: HERRERA FCC AKA CHU CHU TRAIN DAYCARE
FACILITY NUMBER: 426215387
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2023
Section Cited
CCR
102417(a)
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The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence.
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Licensee will submit a written plan of correction on how licensee will ensure children are supervision at all times to CCLD by 09/27/23, via email to: Martina.Jimenez@dss.ca.gov
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Licensee stated on 8/29/23 & 9/14/23, while picking up a child from school, the assistant advised the licensee that C1 bit C2 on the shoulder for the second time. The assistant was caring for 10 children, which posed a potential risk to the health and safety of children in care.



, which posed a potential risk to the health and safety of children in care.
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Type B
09/27/2023
Section Cited
CCR
102416.2(a)
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The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm). Licensee failed to report incident to parent & to CCLD within 24 hours of the incident, which posed a potential risk to the health and safety of children in care.
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Licensee will submit a written plan of correction on how licensee will ensure parents and CCLD are notified of incidents with 24 hours of the incident to CCLD by 09/27/23, via email to: Martina.Jimenez@dss.ca.gov
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 17-CC-20230915122639
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: HERRERA FCC AKA CHU CHU TRAIN DAYCARE
FACILITY NUMBER: 426215387
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2023
Section Cited
CCR
102419(d)(2)
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Whenever a parent or authorized representative makes a request pursuant to Section 102419(a)(8), the licensee shall note, date, and initial the request in the child’s file. The licensee shall request that the parent or authorized representative also initial the notation
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Licensee will submit a written plan of correction on how licensee will abide by the admissions policy and prevent future incident to CCLD by 09/27/23, via email to: Martina.Jimenez@dss.ca.gov
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documenting the request. Licensee stated on 9/6/23, licensee picked up C3 from school and proceeding to Whispering Tree Nursery with C3, which posed a potential risk to the health and safety of children in care.
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4