566212783-9-25-2019-17-CC-GMIE-BGKVBA-20191002161709

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 566212783
Report Date: 09/25/2019
Date Signed: 09/25/2019 01:06:15 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
09/20/2019 and conducted by Evaluator Francisco Pedroza

PUBLIC

COMPLAINT CONTROL NUMBER: 17-CC-20190920161832

FACILITY NAME:	CDI - DEL NORTE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	566212783
ADMINISTRATOR:	RACHEL CHAMPAGNE		FACILITY TYPE:	850
ADDRESS:	2500 LOBELIA DR.		TELEPHONE:	(805) 988-3983
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY:	72	CENSUS: 44	DATE:	09/25/2019
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Jennifer Escamilla		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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9

Absence of Supervision

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Francisco Pedroza and Betzayra Cervantes made an unannounced inspection to initiate a complaint investigation into the above allegation. LPAs met with facility Site Supervisor Jennifer Escamilla and discussed the nature and purpose of the visit. LPA's and Site Supervisor together toured the facility inside and out.

Allegation stated the facility had one child outside of the classroom without staff supervision and knowledge. The child's parent arrived to pick up their child and found them alone outside. According to staff the child was outside about one and half to two minutes alone. The facility has acknowledged the incident occurred and since then has implemented new procedures to ensure the incident will not reoccur. Based on LPAs observations and interviews which were conducted and record review(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 12 & Chapter number 1), are being cited on the attached LIC 9099D. Licensee was issued a Type "A" deficiency and civil penalty. Appeal rights were provided.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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-20190920161832

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: CDI - DEL NORTE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 566212783
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/25/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/25/2019 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	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.. shall include visual observation. This requirement is not met as evidence by:	1 2 3 4 5 6 7	Licensee has agreed to submit a letter to the Department no later than 10/02/2019 explaining the circumstances that led to this incident and what actions the facility has implemented to prevent a similar incident from reoccurring. The facility will submit the letter via fax (805) 685-1820 or email to francisco.pedroza@dss.ca.gov.
	8 9 10 11 12 13 14	Teacher staff confirmed the child outside the classroom without staff supervision for about one and half to two minutes. The child's parent informed staff about the incident. This poses an immediate Health and Safety risk to clients / children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

LIC9099 (FAS) - (06/04)

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