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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 561701236
Report Date: 11/26/2019
Date Signed: 11/26/2019 03:58:50 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
09/09/2019 and conducted by Evaluator Jill M Hazelhofer-Laxo
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20190909140804
FACILITY NAME:FIRST UNITED METHODIST PRESCHOOL & CHILD CARE C.FACILITY NUMBER:
561701236
ADMINISTRATOR:ELIZABETH STRASSWYKFACILITY TYPE:
850
ADDRESS:1338 EAST SANTA CLARA STREETTELEPHONE:
(805) 653-5304
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:61CENSUS: 21DATE:
11/26/2019
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Elizabeth StrasswykTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Personal Rights-Staff failed to prevent day care child from being bit by another child in care
Level of Care-Staff failed to adequately supervise day-care children resulting in injuries and Staff are failing to provide a safe environment for the children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jill Laxo conducted an unannounced inspection to conclude a complaint investigation. LPA met with Director, Elizabeth Strasswyk and advised the purpose of the inspection. Director was present in the Toddler Component, due to staff shortage. There were 21 children supervised by three staff in three separate classrooms.

Complaint received alleged "Staff failed to prevent day care child from being bit by another child in care, staff failed to adequately supervise day-care children resulting in injuries, and staff are failing to provide a safe environment for the children.” Investigation included three unannounced inspections, interviews with complainant, parents, Director and record review.

During the initial complaint inspection 09/17/2019, the referenced allegations were found to need further investigation. Evidence gathered from record review and LPA’s interview with Director and parents found the licensee failed to provide necessary care and supervision to meet the children needs, which resulted in injuries to children in care. Based on interviews and record review the licensee failed to provide authorized representatives with adequate notification of injuries that children sustained in care.
Continued on 9099C

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019
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-20190909140804
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: FIRST UNITED METHODIST PRESCHOOL & CHILD CARE C.
FACILITY NUMBER: 561701236
VISIT DATE: 11/26/2019
NARRATIVE
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Based on LPA's observations, interviews which were conducted, documents gathered and/or record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) are SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Ch. 1 article 06 are being cited on the attached LIC 9099D.

Two Type B deficiencies are being cited today.

An exit interview was conducted and Plans of Corrections were reviewed and developed with the Director. A copy of this report and appeal rights were discussed and left with Director, Elizabeth Strasswyk, whose signature on this form confirms receipt of these documents.

The notice of site visit was provided to licensee and LPA observed licensee post LIC9123.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20190909140804
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: FIRST UNITED METHODIST PRESCHOOL & CHILD CARE C.
FACILITY NUMBER: 561701236
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2019
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision: (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time,...Supervision shall include visual observation.
This requirement is not met as evidenced by:
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Licensee will create a plan of operation which ensures children have visual supervision/ observation at all times. Plan will be emailed to LPA by 12/06/2019.
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Based on interviews and record review the licensee failed to provide necessary care and supervision to meet the childrens needs in the Toddler Component, which poses a potential Health, Safety or Personal Rights risk to the children in care.
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Type B
12/06/2019
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights: (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
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Licensee will provide training to staff on creating a safe environment for children. Licensee will provide a guideline for staff that outline procedures for notifying authorized representatives when a child is injured in care. Documentation of training will be emailed to LPA by 12/06/2019.
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Based on interviews and record review the licensee failed to ensure the children in the Toddler component were accorded a safe environment to meet their needs, which poses a potential Health, Safety or Personal risk to the 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: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3