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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313965
Report Date: 01/03/2024
Date Signed: 01/03/2024 03:43:37 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
12/01/2023 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231201170807
FACILITY NAME:SOTO DELGADILLO, MARIBELFACILITY NUMBER:
304313965
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
01/03/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Maribel Soto, LicenseeTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Day care child fell and sustained an injury due to lack of supervision.
INVESTIGATION FINDINGS:
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*** This report was translated into Spanish by LPA Valdez Santana ***

Licensing Program Analyst (LPA) Nguyen Nick Tran and LPA Dianna Valdez Santana conducted an unannounced complaint inspection to deliver the findings for the above allegation. This is a continuation of the investigation initiated on 12/04/23. At 01/03/2024, LPA Tran met with Licensee Maribel Soto, who guided LPA on tour of the facility. Census was taken and observed were 4 children were supervised by Licensee and assistant.

A review of the Facility Personnel Report Summary on 01/03/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 12/01/2023, the Regional Office received a complaint with allegation alleging Day care child fell and sustained an injury due to lack of supervision. (Continue next page)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
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-20231201170807
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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965
VISIT DATE: 01/03/2024
NARRATIVE
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(Page 2 of Report)

During a confidential interview, it was reported that child #1 (C1) sustained a head injury due to the lack of supervision while in the day care.

During investigation, LPA conducted observations on 12/04/2023 and 12/05/2023, interviewed 1 adult and 4 parents.

During the visit 12/04/2023, at 10:30am, LPA Tran and LPA Navar observed Adult #1 (A1) was going back and forth between the living room and the outdoor area. A1 left the sliding door between the living room and the outside area open. LPAs observed C2 fell as C2 was going down the steps. LPAs addressed concerns with A1 and A1 closed the sliding door. A1 was reminded to ensure supervision is provided during transition or to keep the sliding door closed when all children has transitioned outside. At 10:47am, LPA Tran and LPA Navar observed C3 was alone crying under a table on the side of the backyard as A1 was busy with other children. LPAs addressed the concern of supervision with A1 and A1 brought C3 to join with the group of children.

During the visit on 12/05/2023, LPA Tran and LPA Valdez Santana observed C4 walked into the kitchen without adult's supervision and was looking into the open dryer, and the dryer's door was open. A1 was busy placing another into the playpen in the bedroom. LPAs addressed concern with A1 and advised A1 to ensure supervision is provided and kept the dryer's door closed if not in use. Licensee closed the dryer's door.

When interviewed, A1 admitted that A1 did not witness C1 fall. A1 stated that A1 was walking away from C1 into the kitchen, when C1 fell in the living room and hit C1’s head on the hard part of the floor and sustained a bruise. A1 stated A1 provided first aid and informed child’s representative at pick-up. Interviewed parents did not share any concern related to the allegation.


(Continue next page)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 06-CC-20231201170807
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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965
VISIT DATE: 01/03/2024
NARRATIVE
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(Page 3 of Report)

Based on the information gathered from LPA's observations during visits on 12/04/23 and 12/05/2023 and interviews conducted with 1 adult and 4 parents, the preponderance of evidence standard has been met, therefore the above allegation of Day care child fell and sustained an injury due to lack of supervision
is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1,
102417 (a) Operation of a Family Child Care Home is being cited on the attached LIC9099D.

Appeal Rights and deficiency were discussed. The facility representative was provided with a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. Notice of site visit was given and must remain posted for 30 days. An exit interview was conducted, and the report was reviewed with Licensee Maribel Soto in Spanish.

Due to the Type A violation cited today, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 06-CC-20231201170807
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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/10/2024
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home (a)The licensee shall be present in the home and shall ensure that children in care are supervised at all times...
This requirement is not met as evidenced by:
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Licensee states she will develop a plan to ensure she can provide supervision for the children in care, and submit the plan to LPA via email by due date.
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Based on LPA's observations and interviews, A1 did not ensure supervision was provided to the children in care, resulting in C1's injury. This posed an immediate health, safety and personal rights risk to 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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4