566207168-11-17-2022-17-CC-MMUR-CLVNEU-20221207092427

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 566207168
Report Date: 11/17/2022
Date Signed: 11/17/2022 10:20:19 AM

Unsubstantiated

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
09/01/2022 and conducted by Evaluator Rona Chavez

PUBLIC

COMPLAINT CONTROL NUMBER: 17-CC-20220901082520

FACILITY NAME:	FERNANDEZ FCC AKA LUPITA'S FAMILY CHILD CARE		FACILITY NUMBER:	566207168
ADMINISTRATOR:	LEONOR FERNANDEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 983-2063
CITY:	OXNARD	STATE: CA	ZIP CODE:	93030
CAPACITY:	14	CENSUS: 8	DATE:	11/17/2022
		UNANNOUNCED	TIME BEGAN:	09:01 AM
MET WITH:	Guadalupe Fernandez		TIME COMPLETED:	10:38 AM

ALLEGATION(S):

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Personal Rights

INVESTIGATION FINDINGS:

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On 11/17/2022 at 9:01 AM, Licensing Program Analyst (LPA) Rona Chavez conducted an unannounced complaint inspection to conclude the investigation of the above allegation. LPA Chavez met with licensee Lupita Fernandez and explained the purpose of the inspection. Licensee and LPA Chavez conducted a tour of the home inside and out. There were 8 children present.

The allegation is that a child who was enrolled in the daycare, bottle was not properly washed. Investigation included interviewing complainant, both licensees, staff assistant, parents of children in care and obtaining photo documentation and observing bottles in the facility. Licensee denies the allegation. None of the staff or parent interviews corroborated the allegation. Staff interviews and parents confirmed that parents bring the bottles for the children.

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 17-CC-20220901082520

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: FERNANDEZ FCC AKA LUPITA'S FAMILY CHILD CARE	FACILITY NUMBER: 566207168
	VISIT DATE: 11/17/2022

NARRATIVE

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LPA Rios observed all dishes in the home on 9/1/2022 and all bottles and dishes were observed to be clean and free of any mold. There is no evidence to support where the bottle came from and who it belonged to. Although this allegation may have occurred, there is not a preponderance of evidence to prove that the alleged violations did or did not occur, therefore, the allegation listed above is deemed UNSUBSTANTIATED.

Exit interview was conducted with Lupita Fernandez. 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 Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

LIC9099 (FAS) - (06/04)

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