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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 421712405
Report Date: 01/23/2023
Date Signed: 01/23/2023 03:54:58 PM

Unsubstantiated


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
11/09/2022 and conducted by Evaluator Maryrose Breault
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20221109100100
FACILITY NAME:GIRLS INCORPORATED OF CARPINTERIAFACILITY NUMBER:
421712405
ADMINISTRATOR:COLLINS, JAMIEFACILITY TYPE:
840
ADDRESS:5315 FOOTHILL ROADTELEPHONE:
(805) 684-6364
CITY:CARPINTERIASTATE: CAZIP CODE:
93013
CAPACITY:100CENSUS: 55DATE:
01/23/2023
UNANNOUNCEDTIME BEGAN:
02:43 PM
MET WITH:Gloria FloresTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unqualified staff are supervising children.
Facility operating out of ratio.
Staff transporting children without valid license.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On January 23rd, 2023, at 2:43PM Licensing Program Analyst (LPA) Rosie Breault, made an unannounced inspection to conclude the complaint listed above. LPA met with Human Resources and Operations Director Gloria Flores and explained the nature and purpose of the inspection. Director provided LPA a tour of the facility. At the time of the inspection there were fifty-five (55) children present and 5 (five) staff.
The Department (Dept.) obtained allegations that unqualified staff are supervising children, staff without valid driver’s license are transporting children, and facility is operating out of ratio.
During the investigation, facility provided the Dept. with file records, current CA Driver’s License for staff that transport children, and staff education verification regarding the allegations to which the Department reviewed.
Based on LPA’s observation, review of type of vehicle being used for transportation, CA drivers license verification, staff education records, and file review, the preponderance of evidence standard has not been met. Although the above allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation is UNSUBSTANTIATED.
Exit interview with Ms. Flores, copy of report provided with appeal rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023
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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