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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 561710698
Report Date: 08/05/2022
Date Signed: 08/05/2022 02:51:46 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
05/10/2022 and conducted by Evaluator Austin Rios
COMPLAINT CONTROL NUMBER: 17-CC-20220510140140
FACILITY NAME:HOLY CROSS FAMILY PRE-SCHOOL AND DAY CAREFACILITY NUMBER:
561710698
ADMINISTRATOR:SAMANTHA JULIASFACILITY TYPE:
840
ADDRESS:1212 MARICOPA HIGHWAYTELEPHONE:
(805) 646-8121
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:35CENSUS: 20DATE:
08/05/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Alex MolinaTIME COMPLETED:
01:29 PM
ALLEGATION(S):
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Personal Rights-Daycare child inappropriately touched multiple daycare children
INVESTIGATION FINDINGS:
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 Licensing Program Analyst (LPA) Austin Rios made an unannounced visit to conclude a complaint investigation. LPA met with office manager Alex Molina and together toured the facility inside and out. During the inspection there were 20 chhildren in Care and two teachers providing supervision.

Allegation stated that there has been inappropriate touching child to child. LPA contacted RP on 5/27/2022. Reporting Party (RP) stated that a child in the school-age classroom was touching other children. RP states that director was aware and told staff to expect licensing to come and they know that the age groups should not be mixing. The investigation included two (2) unannounced inspections, interviews with past and present staff and parents, Director, record reviews and LPA observations. Multiple witnesses confirmed that preschool children that did not want to nap were allowed to comingle with the school-age program. Documentation provided by center confirmed that an incident happened with a school age child and two (2) preschool children. Interviews confirmed that there has been more than once incident that occurred.
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: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
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 3
Control Number 17-CC-20220510140140
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: HOLY CROSS FAMILY PRE-SCHOOL AND DAY CARE
FACILITY NUMBER: 561710698
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/05/2022
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...
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Facility willl provide a written statement of how the facility will ensure that visual supervision will be met and submit to LPA via email rona.chavez@dss.ca.gov. Facility will also be meeting in the licensing office for a conference.
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Based on LPAs interviews and documentation provided by center, confirmed that an incident happened with a school age child and two (2) preschool children

This poses an immediate risk to the health and safety of 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) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20220510140140
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: HOLY CROSS FAMILY PRE-SCHOOL AND DAY CARE
FACILITY NUMBER: 561710698
VISIT DATE: 08/05/2022
NARRATIVE
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. Based on interviews, record reviews, and LPAs observation the preponderance of evidence has been met. Therefore, the above the allegation has been substantiated. A Type A deficiency (Title 22 California Code of Regulations 101229(a)(1) ) is being cited on the attached LIC 9099D.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3