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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566208716
Report Date: 11/08/2022
Date Signed: 11/08/2022 01:05:53 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
11/04/2022 and conducted by Evaluator Laura Villanueva
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20221104095221
FACILITY NAME:ALCAZAR FAMILY CHILD CAREFACILITY NUMBER:
566208716
ADMINISTRATOR:NAOMI ALCAZARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 483-8721
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 7DATE:
11/08/2022
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Naomi AlcazarTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Unfingerprinted person is providing care and supervision to children
INVESTIGATION FINDINGS:
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On November 8, 2022 at 11:30 AM Licensing Program Analyst (LPA) Laura Villanueva made an unannounced inspection to initiate the investigation for the above allegation. LPA met with Licensee, Naomi Alcazar and explained the purpose of the inspection. LPA asked pre-screening questions related to COVID-19. Licensee’s responses suggest no COVID exposure on site. LPA and Licensee conducted a tour of the facility inside and outside. LPA observed a total of 7 children under the care and supervision of 2 staff.

When LPA arrived, Assistant did not allow LPA to enter home until Licensee arrived. Licensee was informed that Licensing has inspection authority to enter the home. A type B violation was issued. LPA reviewed the facility roster on Guardian with Licensee. Licensee's new assistant S1 is in process for fingerprint clearance. Licensee has copy of letter stating that S1 has been fingerprinted on 06/14/22. LPA issued a citation for a an adult working at the home without fingerprint clearance.

Continued on LIC809 C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
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 4
Control Number 17-CC-20221104095221
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: ALCAZAR FAMILY CHILD CARE
FACILITY NUMBER: 566208716
VISIT DATE: 11/08/2022
NARRATIVE
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Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 9099 and LIC 9099 D.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

Licensee Naomi Alcazar was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Substantiated – “Based on LPAs observations and interviews which were conducted and record reviews (s), the preponderance of evidence standard has been met, therefore the above allegation (s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.”)

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 17-CC-20221104095221
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: ALCAZAR FAMILY CHILD CARE
FACILITY NUMBER: 566208716
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/08/2022
Section Cited
HSC
102370(d)(1)
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102370(d)(1)-Criminal Record Clearance-All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by: Assistant's fingering clearance is in process since 614/22.
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Assistant was not present at child care today. LPA informed Licensee that a criminal recpord clearance needs to be granted clerance before returning to the home.
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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: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 17-CC-20221104095221
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: ALCAZAR FAMILY CHILD CARE
FACILITY NUMBER: 566208716
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/08/2022
Section Cited
HSC
102391(a)
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102391 (a) Inspection authority of the department-(a) Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, enter and inspect any place providing personal ..., and in accordance with Section 102396.
This requirement as not met as evidenced by: Assistant not allowing LPA to enter home.
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Licensee was reminded that Licensing representatives have inspection authority to enter home during businessz hours.
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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: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4