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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313952
Report Date: 10/08/2025
Date Signed: 10/08/2025 12:26:50 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/06/2025 and conducted by Evaluator Giselle Lucero
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20251006111959
FACILITY NAME:NAVARRO, PATRICIAFACILITY NUMBER:
304313952
ADMINISTRATOR:NAVARRO, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 586-1563
CITY:SANTA ANASTATE: CAZIP CODE:
92701
CAPACITY:14CENSUS: 4DATE:
10/08/2025
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Adult Middka VicencioTIME COMPLETED:
11:55 AM
ALLEGATION(S):
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Licensee allowed adult(s) to reside in the home without an associated criminal record clearance.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Giselle Lucero conducted a complaint visit regarding the above complaint allegation. Upon arrival, LPA was met by adult Middka Vicencio, LPA observed a total of 4 children which included 1 infant and 3 preschool age children. Assistant stated Licensee was out running errands.

A review of facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Department received a complaint on 10/06/2025 alleging the licensee allowed adult(s) to reside in the home without an associated crimil record clearance.

(continue to page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
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 06-CC-20251006111959
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: NAVARRO, PATRICIA
FACILITY NUMBER: 304313952
VISIT DATE: 10/08/2025
NARRATIVE
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(Page 2)

Reporting party (RP) reported the Licensee has family member living in the home for over a month and the adults have no background clearances.

Upon arrival, the Licensing Program Analyst (LPA) observed an adult female (Adult #1 - A1) sleeping on the couch in the living room. When questioned, A1 provided their name. A review of the Guardian Background system confirmed that A1 is fingerprint cleared as of 08/15/2025. It was also confirmed that Adult #2 (A2) has been fingerprint cleared since 2023.

LPA conducted interviews with the adults present. One adult reported that there are currently four adults residing in the home: the Licensee, the Licensee’s son, A1, and an individual named Alvaro Flores, described as a friend of the Licensee who has been living in the home since September 2025.

A2 stated that they are not a regular assistant at the facility and only visit every few months when assistance is needed by the Licensee. A2 further stated that, to their knowledge, only the Licensee, the Licensee’s son, and A1 reside in the home. A2 was unfamiliar with Alvaro Flores and could not confirm his identity or relationship to the Licensee.

The Licensee arrived at the facility at 9:53 AM. LPA informed the Licensee of the purpose of the visit and explained that a full tour of the home would be conducted. The Licensee granted access to all bedrooms. During the walk through, LPA observed an adult male identified as Alvaro Flores sleeping in one of the bedrooms. When asked, the Licensee stated that Alvaro is her nephew, recently moved in, and was scheduled to complete his fingerprint clearance later that day. The Licensee explained that Alvaro typically works and is only present in the home at night and today he is present due to having the day off.

LPA interviewed Alvaro Flores (Adult #3 - A3), who confirmed he is the Licensee’s nephew. He was unsure of his exact move-in date but indicated he has been residing in the home since approximately September 2025. A3 stated he is usually only present at night due to work.

LPA observed A3 leave the premises to complete his fingerprint clearance.
(Continue to page 3)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 06-CC-20251006111959
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: NAVARRO, PATRICIA
FACILITY NUMBER: 304313952
VISIT DATE: 10/08/2025
NARRATIVE
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(Page 3)

A review of the Guardian Background system confirmed that Alvaro Flores has not received criminal background clearance.This is a violation of Health and Safety Code Section 1596.871. A civil penalty of $500 will be assessed today; see LIC 809D for deficiency.



Based on LPA's observations, review of Guardian Background check, and interviews conducted with adults and licensee, it has been determined Licensee allowed adult to reside in the home without an associated criminal record clearance. Therefore, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22, Administration of Child Day Care Licensing 1596.871(c)(1)(A) is being cited on the attached LIC 9099D.

LPA Lucero informed licensee Patricia Navarro that this report dated 10/08/2025 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.



Also, LPA Lucero informed the licensee to provide a copy of this licensing report dated 10/08/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Licensee Patricia Navarro. A notice of site visit was given and must remain posted for 30 days. Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights.

End of Report.

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 06-CC-20251006111959
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NAVARRO, PATRICIA
FACILITY NUMBER: 304313952
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/08/2025
Section Cited
HSC
1596.871(c)(1)(A)
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1596.871 Administration of Child Day Care Licensing (c)(1)(A).. a person.. who is not exempt from fingerprinting shall obtain either a criminal record clearance.. prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by :
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Licensee sent Alvaro to get fingerprinted during visit and Alvaro returned and showed copy of live scan form completed and left the premises. Licensee understands if fingerprint does not come back cleared, Alvaro cannot reside in the home and must leave immediately.
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Based on observation, interview and record review, the licensee did not comply with the section cited above. Alvaro Flores does not obtain a criminal record clearance and has been present at the facility since Sept. 2025. This poses an immediate health, safety or personal rights risk to persons 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.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4