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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393621116
Report Date: 08/21/2025
Date Signed: 08/21/2025 11:32:28 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/15/2025 and conducted by Evaluator David Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20250815162003
FACILITY NAME:VILLA MONTECITO - SUSD HEAD STARTFACILITY NUMBER:
393621116
ADMINISTRATOR:SANZ, ELIZABETHFACILITY TYPE:
850
ADDRESS:1339 KINGSLEY AVENUETELEPHONE:
(209) 547-9088
CITY:STOCKTONSTATE: CAZIP CODE:
95203
CAPACITY:20CENSUS: 7DATE:
08/21/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Hettervik, IreneTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility does not meet fire safety measures.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), David Nguyen met facility representative Irene Hettervik for the purpose of initiating and closing a complaint investigation. The purpose of the inspection was explained. LPA toured the facility. There were seven (7) children present being supervised by three (3) teachers during today’s visit.

It was alleged that "Facility does not meet fire safety measures." During the investigation, LPA Nguyen inspected the facility, conducted onsite interview with facility representative, and telephone interview with reporting party, and obtained pertinent documents to assist with the complaint investigation. During the interview with reporting party, it was revealed that the childcare facility does not meet fire safety measures because the childcare facility does not have functioning smoke detectors as required by the fire department.


Report continues on LIC9099-C.... (Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
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 3
Control Number 53-CC-20250815162003
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: VILLA MONTECITO - SUSD HEAD START
FACILITY NUMBER: 393621116
VISIT DATE: 08/21/2025
NARRATIVE
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(Page 2)
During the interviews, LPA Nguyen found collaborating information regarding the allegation. Based on interviews and record reviews, it was found that the facility was out of compliance for maintaining the fire clearance due to violations found at the last fire inspections on 8/15/2025 that have not been corrected as of this date

Based on corroborating information from reporting party’s interview and record reviews, there is a preponderance of evidence to prove the alleged violation did occur at the facility. Therefore, the above allegation is found to be SUBSTANTIATED.

The following Title 22 Deficiency is being cited on the subsequent 9099-D page. Upon receipt of Type-A citations, Facility Representative shall provide copies of the LIC 9099-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Facility representative must also keep the signed LIC 9224, acknowledging receipt of LIC 9099-D in each child's file.

Appeal Rights were provided, and LPA posted a Notice of Site Visit and 9099-D page dated 8/21/2025 which must remain posted for 30 days.

Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.

An exit interview was conducted with facility representative. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20250815162003
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: VILLA MONTECITO - SUSD HEAD START
FACILITY NUMBER: 393621116
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/22/2025
Section Cited
CCR
101171(a)
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101171(a) Fire Clearance
(a) All child care centers shall secure and maintain a fire clearance approved by the city or county fire department….
This requirement was not met as evidenced by:
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Facility representative will provide a written statement and supporting documentation on how they are going to correct violations as per the fire inspection report dated 8/15/25 to meet fire safety measures.
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Based on record reviews and interviews, the facility was out of compliance for fire clearance due to lack of smoke detectors which posed an immediate health, safety, or personal rights risks to children in care.
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The facility will not operate a child care program until fire clearance requirements have been met. Families will be offered openings at other programs until the facility can re-open.
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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: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3