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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426215565
Report Date: 06/20/2022
Date Signed: 06/20/2022 01:54:21 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
04/05/2022 and conducted by Evaluator Austin Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20220405080629
FACILITY NAME:CHACON FAMILY CHILD CAREFACILITY NUMBER:
426215565
ADMINISTRATOR:EDIS Y. CHACONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 636-3211
CITY:SANTA BARBARASTATE: CAZIP CODE:
93103
CAPACITY:14CENSUS: 6DATE:
06/20/2022
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Edis ChaconTIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Personal Rights-Staff did not ensure that day care children were supervised appropriately.
INVESTIGATION FINDINGS:
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On June 20, 2022 at 1:15 PM, Licensing Program Analysts (LPA) Austin Rios and (LPA) Mayrose Breault conducted an unannounced inspection to conclude a complaint investigation. LPA met with license Edis Chacon and explained the nature and the purpose of the inspection.LPAs asked Covid-19 screening questions prior to entering the home. Licensee provided LPA a tour of the facility inside and out. There were six children in care at the time of the inspection. The department obtained an allegation that staff did not ensure day care children were supervised appropriately.

Interviews were conducted with Complainant, Parents of children in care, assistant, licensee, and LPA reviewed C#1 file. On 4/4/22 C#1 face was scratched while in day care, Photos were submitted to LPA. Parents were interviewed and expressed satisfaction with care and supervision of children. Based on children interviewed, two children were scratched before in the past which corroborated the allegation. Interview with licensee and assistant revealed that there were multiple incidents of scratching that licensee observed and was present during the incidents. Licensee separated the children and re-directed.



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

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
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-20220405080629
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: CHACON FAMILY CHILD CARE
FACILITY NUMBER: 426215565
VISIT DATE: 06/20/2022
NARRATIVE
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This agency has investigated the complaint alleging, staff did not ensure day care children were supervised appropriately. and based on interviews conducted and documentation obtained, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED.
Licensee is being given a type c technical violation for supervision Title 22 Division 12 102417(a) on attached LIC9102 page.

Exit interview was conducted with licensee. The Notice of Site Visit (LIC9213) was posted. 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: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2