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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426214409
Report Date: 01/10/2025
Date Signed: 01/10/2025 02:39:38 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 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
04/10/2024 and conducted by Evaluator German Negrete
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20240410130630
FACILITY NAME:VILLAGE VALLEY PRESCHOOLFACILITY NUMBER:
426214409
ADMINISTRATOR:MARIA E. ANGULOFACILITY TYPE:
850
ADDRESS:3346 CONSTELLATION ROADTELEPHONE:
(805) 733-7330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:32CENSUS: 5DATE:
01/10/2025
UNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Maria AnguloTIME COMPLETED:
03:01 PM
ALLEGATION(S):
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Day care child sustained unexplained arm fracture while in care
INVESTIGATION FINDINGS:
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On 1/10/2025, Licensing Program Analysts (LPAs) German Negrete and Sylvia Ceja conducted an unannounced inspection at Village Valley Preschool (facility) to deliver the findings of the complaint allegations received by the Regional Office (RO) on 4/10/2024. LPAs met with Director Maria Angulo. LPAs explained the purpose of the inspection and conducted a tour of the preschool, both inside and outside. At the time of the inspection, the child-to-staff ratio was 1children under the supervision of 1 staff members.

On 04/10/2024, the RO referred this case to the Investigations Branch. On 04/11/2024, Investigator John Canto was assigned to investigate the allegation of neglect regarding child C47for sustaining a fracture while in care (See Attachment #1). This allegation was investigated by the Department’s Investigation Bureau (IB). During the investigation, the Investigator conducted interviews with parents of enrolled children, current and former staff members, and the facility administrator. Medical records and unusual incident reports were also reviewed. Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 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
04/10/2024 and conducted by Evaluator German Negrete
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20240410130630

FACILITY NAME:VILLAGE VALLEY PRESCHOOLFACILITY NUMBER:
426214409
ADMINISTRATOR:MARIA E. ANGULOFACILITY TYPE:
850
ADDRESS:3346 CONSTELLATION ROADTELEPHONE:
(805) 733-7330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:32CENSUS: 5DATE:
01/10/2025
UNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Maria AnguloTIME COMPLETED:
03:01 PM
ALLEGATION(S):
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9
Facility staff did not seek appropriate medical attention for child's injury
Facility staff did not properly notify child's responsible person of injury
INVESTIGATION FINDINGS:
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On 1/10/2025, Licensing Program Analysts (LPAs) German Negrete and Sylvia Ceja conducted an unannounced inspection at Village Valley Preschool (facility) to deliver the findings of the complaint allegations received by the Regional Office (RO) on 4/10/2024. LPAs met with Director Maria Angulo LPAs explained the purpose of the inspection and conducted a tour of the preschool, both inside and outside. At the time of the inspection, the child-to-staff ratio was 1 child under the supervision of 1 staff member.

On 04/10/2024, the RO referred this case to the Investigations Branch. On 04/11/2024, Investigator John Canto was assigned to investigate the allegation of neglect regarding child C47 for sustaining a fracture while in care (See Attachment #1). This allegation was investigated by the Department’s Investigation Bureau (IB). During the investigation, the Investigator conducted interviews with parents of enrolled children, current and former staff members, and the facility administrator. Medical records and unusual incident reports were also reviewed by Investigator.
Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 17-CC-20240410130630
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VILLAGE VALLEY PRESCHOOL
FACILITY NUMBER: 426214409
VISIT DATE: 01/10/2025
NARRATIVE
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Allegation #2: Facility staff did not seek appropriate medical attention for child’s injury. Interviews were conducted with facility staff, the facility administrator, and C47’s parent. The interviews revealed that C47 informed the parent about falling backward while playing on the facility’s playground bridge. The fall was not witnessed and unforeseen, occurring at approximately 10:30 AM. Facility staff assessed the injury and applied an ice pack to C47’s wrist. However, C47’s parents were not immediately informed about the incident. They were only notified at the time of pick-up (12:00 PM). The parents were informed that C47 had fallen, but specific details about the injury were not provided. The Facility Administrator later stated that the parents should have been notified immediately of the discomfort C47 displayed on the day of the incident. Staff members also acknowledged that the parents should have been contacted immediately. The facility administrator held a training meeting to discuss ways to prevent similar incidents in the future and contacted the Community Care Licensing, Licensing Program Analyst, for guidance.

Allegation #3: Facility staff did not properly notify the child’s responsible person of the injury.

As mentioned in the investigation of Allegation #2, the interviews revealed that C47’s parents were not immediately informed about the injury. The facility administrator and staff members acknowledged that the parents should have been informed right away. The failure to promptly notify the parents is considered a violation of the facility’s responsibility to ensure appropriate communication regarding children’s well-being.

Based on IB investigators’ observations, interviews, and documents collected during the investigation, the preponderance of evidence standard has been met. Therefore, Allegation #2 and Allegation #3 are substantiated. California Code of Regulations, Title 22, is being cited on the attached LIC 9099D.

The report was read to Director.

LIC9224 (receipts of licensing reports was provided).

Notice of site visit was provided as well as appeal rights.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 17-CC-20240410130630
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VILLAGE VALLEY PRESCHOOL
FACILITY NUMBER: 426214409
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/17/2025
Section Cited
CCR
101223(a)(2)
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he licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Licensee will have a training with staff to go over perosnal rights. Licensee will email the department a signed document stating staff understand the following section of personal rights " healthful and comfortable accommodations, furnishings and equipment to meet his/her needs".
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this requirement was found not to be met.. as.. Through IB investigation, documents and interviews revealed, C47 was not provided healthull accomodations when C47 injured their wrist.
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Type A
01/24/2025
Section Cited
CCR
101226.3(b)
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Any unusual behavior, any injury or signs of illness requiring assessment and/or administration of first aid by staff shall be reported to the child's authorized representative and recorded in the child's record. This requirement is not met, as evident
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Licensee will have a training with staff to go over Observations of a child. Licensee will email the department a signed document stating staff understand the following section of observations of a child " Any unusual behavior, any injury or signs of illness requiring assessment and/or administration
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 by Based on IB investigators’ observations, interviews, and documents collected during the investigation, The failure to promptly notify the parents is considered a violation of the facility’s responsibility to ensure appropriate communication regarding children’s well-being.
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 of first aid by staff shall be reported to the child's authorized representative.
Licensee will email LPA Negrete.
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: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 17-CC-20240410130630
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VILLAGE VALLEY PRESCHOOL
FACILITY NUMBER: 426214409
VISIT DATE: 01/10/2025
NARRATIVE
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Allegation #1: Neglect / Lack of Care & Supervision – Daycare child sustained an unexplained arm fracture while in care

The investigation revealed that 24 children were enrolled at the facility, with five staff members working on 04/08/2024, the day of the incident. None of the staff members witnessed the fall. Three staff members were supervising the children in the yard, while one was inside the facility. According to C47’s mother, C47 reported that while playing on the bridge, C47 fell backward, resulting in a fracture to the left arm. The fall was not witnessed and unforeseen. After reviewing the relevant reports and conducting interviews, the Investigator found no evidence to support the allegation. As a result, Allegation #1 is unsubstantiated.

The report was read to Director. Notice of site visit was provided.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5