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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426210198
Report Date: 07/22/2021
Date Signed: 07/22/2021 11:00:24 AM

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
05/24/2021 and conducted by Evaluator Christian Patterson
COMPLAINT CONTROL NUMBER: 17-CC-20210524154143
FACILITY NAME:ISLA VISTA CHILDREN'S CENTERFACILITY NUMBER:
426210198
ADMINISTRATOR:ERIKA MALDONADOFACILITY TYPE:
850
ADDRESS:6842 PHELPS RD.TELEPHONE:
(805) 968-0488
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:66CENSUS: 28DATE:
07/22/2021
UNANNOUNCEDTIME BEGAN:
10:26 AM
MET WITH:Erika MaldonadoTIME COMPLETED:
11:05 AM
ALLEGATION(S):
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Facility is hazardous
INVESTIGATION FINDINGS:
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On 07/21/21 at 10:26am, Licensing Program Analyst (LPA) Christian Patterson made an unannounced inspection regarding the above allegations. LPA Patterson met with Director Erika Maldonado and delivered the findings of the complaint investigation.

Investigation included interviewing the Site Supervisor, staff, and review of pertinent documents. LPA requested a roster of children in care along with parent contact information. LPA also requested staff contact information. Reporting party stated that maintenance on the roof of the facility caused the outdoor play areas to become unsafe when building materials were left accessible to children and when a roofing tile fell onto the play area nearly striking children and staff who were present. LPA observed and documented roof repair in progress but did not observe roofing materials accessible to children playing outside. Facility did not inform the Regional Office about the roof maintenance prior to beginning the repairs.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Christian Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
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 2
Control Number 17-CC-20210524154143
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: ISLA VISTA CHILDREN'S CENTER
FACILITY NUMBER: 426210198
VISIT DATE: 07/22/2021
NARRATIVE
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Although, interviews with Site Supervisor and staff did corroborate that maintenance had been occurring on the roof of the facility, interviews did not corroborate that a roof tile had fallen in the outdoor play space. Although the allegation may have occurred, there is not a preponderance of evidence to prove that the alleged violation did or did not occur, therefore, the allegation listed above is deemed UNSUBSTANTIATED. The LIC9213 (Notice of Site Visit) was posted during the visit.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Christian Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2