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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216206
Report Date: 10/25/2021
Date Signed: 10/25/2021 12:42:24 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
10/21/2021 and conducted by Evaluator Gigi Reyes
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20211021132244
FACILITY NAME:SMITH FAMILY CHILD CAREFACILITY NUMBER:
426216206
ADMINISTRATOR:MELISSA SMITHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 268-8500
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:14CENSUS: 0DATE:
10/25/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Melissa SmithTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Unlicensed Care
INVESTIGATION FINDINGS:
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On 10/25/2021, Licensing Program Analyst (LPA) Reyes conducted an unannounced inspection to initiate a complaint investigation regarding the allegation of Unlicensed Care. Due to COVID 19 Pandemic, LPA asked pre screening questions before proceeding with the inspection. LPA met with Melissa Smith, home owner and explained the purpose of the inspection. LPA did not observe any children in care.

Based on the interview conducted with Ms. Smith, she moved at the above address on 10/16/2021. Ms. Smith sent the application for change of location which was received by the Department on 10/15/2021. Ms. Smith admitted the allegation of Unlicensed Care, that she was caring for children on October 19 to October 21, 2021. She stated she started caring for children without the License because there were 7 seven families struggling to find a day care provider.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
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 3
Control Number 17-CC-20211021132244
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: SMITH FAMILY CHILD CARE
FACILITY NUMBER: 426216206
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/25/2021
Section Cited
HSC
1596.80
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1596.80 Child day care facilities, licenses
No person, firm, partnership, association, or corporation shall operate, establish, manage, conduct, or maintain a child day care facility in this state without a current valid license, therefor as provided in this act.
This requirement is not met as evidenced by:
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Applicant submitted the application and is waiting for the Pre Licensing Inpection of the home.

Applicant will be called for an Informal Conference at the Goleta Office.
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Based on LPA interview with Ms. Smith, the latter provided care without a license to 7 families on October 19, 20, 21, 2021.
This poses a poitential risk to 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: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20211021132244
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: SMITH FAMILY CHILD CARE
FACILITY NUMBER: 426216206
VISIT DATE: 10/25/2021
NARRATIVE
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Ms. Smith is aware that Operation of Family Child Care Home without License is a violation of Health and Safety Code 1596.80 and CCR, Title 22, Division 12, Section 102357 (a). Applicant was informed if she continues to operate unlicensed child care, she is subject to a $200.00 civil penalty a day assessment on the 16th day from today's date.

The alleged Unlicensed Care is substantiated. The Notice of Operation of Violation was handed to Melissa Smith during the inspection.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) shall be signed and kept in each of the children’s records. 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: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3