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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216036
Report Date: 03/01/2023
Date Signed: 03/01/2023 04:07:43 PM

Substantiated


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
12/19/2022 and conducted by Evaluator Maryrose Breault
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20221219135413
FACILITY NAME:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
426216036
ADMINISTRATOR:MARIA PANTOJAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 245-4684
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:14CENSUS: 15DATE:
03/01/2023
UNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Maria PantojaTIME COMPLETED:
04:22 PM
ALLEGATION(S):
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5
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7
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9
Care and Supervision
Care and Supervision
Ratio
INVESTIGATION FINDINGS:
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5
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13
On March 1st, 2023, at 1:35PM Licensing Program Analyst (LPA) Rosie Breault conducted an unannounced inspection to conclude a complaint initiated on 12/23/2022. At the time of the inspection there were fifteen (15) children in care, and two (2) staff.
The investigation included obtaining the childcare roster, interviewing reporting party (RP), interviewing current and former parents of children in care, reviewing all documents, and file analysis of this Family Child Care Home (FCCH).
All three allegations have been investigated and the findings are as follows:

Allegation 1 CARE AND SUPERVISION: Licensee did not supervise children while sleeping. Reporting party (RP) advised the Department that children were visually seen napping in an enclosed room, with door closed, rendering no visual supervision by the licensee or assistant. RP stated licensee’s assistant was present in the family childcare home (FCCH) however no napping checks were observed. RP reported licensee left the FCCH for roughly 15-20 minutes and during that time, no infants sleeping were checked and door remained closed. Licensee disclosed to RP that a baby monitor was used by her (licensee’s) assistant. RP reported that mandatory 15-minute checks were not being adhered to. Although napping ledger present, the timing of the 15-minute checks appeared to be pre-filled on 15-minute increments and no signatures or initials of licensee or assistant present. RP stated a follow up visit occurred one week later, and at that time, safe sleep was not being practiced and napping children were not being supervised. Based on LPA's interviews, document reviews, and file analysis which reveal that children are not being properly supervised under Title 22 Division 12 102425 (j) (1) (2). The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. A Type B violation has been cited.
CONTINUED ON LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
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 6
Control Number 17-CC-20221219135413
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: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216036
VISIT DATE: 03/01/2023
NARRATIVE
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Allegation 2 CARE AND SUPERVISION: Licensee did not ensure that door to room where infants were sleeping remained open. Reporting party (RP) advised the Department that children were visually seen in an enclosed room, with door closed, rendering no visual supervision by the licensee or assistant. Based on parent interviews, parent(s) disclosed that children are in a separate room with the door closed and licensee does open the door to wake child upon sign out. Parent stated children are napping in a “back room” with a sound machine and monitor. RP stated a follow up visit occurred one week later, and at that time, safe sleep was not being practiced and napping children were napping with the door closed. At the time of the inspection, LPA observed door to napping room was closed with four infants in separate cribs asleep and items (blankets, books) located inside cribs. Based on LPA's interviews, LPA observation, document reviews, and file analysis which reveal that children are not being properly supervised under Title 22 Division 12 102425 The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. A Type A violation has been cited.

Allegation 3 RATIO: Licensee does not operate within ratio. RP stated in one day, four (4) infants, 5 (five) preschool and an additional one (1) to (2) children were dropped off during licensee’s brief absence. At that time, assistant was left alone with children out of capacity. RP stated a follow up visit occurred one week later, and at that time, ratio of a small FCCH was not being adhered to. At the time of the inspection (3/1/2023); licensee was caring for five (5) infants, nine (9) day-care children and one (1) school age child. Based on LPA's interviews, and LPA observation which reveal that licensee was operating out of ratio. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. A Type B violation has been cited.

Exit interviewed conducted, reported review with licensee. Copy of report, LIC9224, and Appeal Rights provided to licensee.

LPA provided Safe Sleep FAQs, Individual Sleep Plan and Ratio chart to licensee.

THE NOTICE OF SITE VISIT WAS GIVEN AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
12/19/2022 and conducted by Evaluator Maryrose Breault
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20221219135413

FACILITY NAME:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
426216036
ADMINISTRATOR:MARIA PANTOJAFACILITY TYPE:
810
ADDRESS:519 WENTWORTH AVE.TELEPHONE:
(805) 245-4684
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:14CENSUS: 15DATE:
03/01/2023
UNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Maria PantojaTIME COMPLETED:
04:22 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Care and Supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
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9
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Allegation 3 CARE AND SUPERVISION: Licensee is using a baby walker on the premises. RP stated visually observed a baby walker on the premises of the FCCH. Baby walker was described as being a combination walker and extra baby saucer. During LPA interviews, parents did not corroborate allegation. RP stated a follow up visit occurred one week later, and at that time, the baby walker had been removed. Based on LPA's interviews, and LPA visual observation, the preponderance of evidence standard has not been met; therefore, the above allegation is found to be UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 17-CC-20221219135413
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: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/01/2023
Section Cited
CCR
102425
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Cribs or play yards shall be free from all loose articles and objects...the door to the room the infant is sleeping in shall remain open at all times
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Licensee to review Safe Sleep documents and submit in writing how she will comply with the regulations to LPA via email: maryrose.breault@dss.ca.gov by 3/15/2023.
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This evidence is met by....

LPA observed nap room door closed and loose objects (blankets and books) within the four (4) cribs
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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: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 17-CC-20221219135413
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: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2023
Section Cited
CCR
102425(j)(1)
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7
The provider shall physically check on the infant every 15 minutes.
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Licensee to provide a completed Safe Sleep log for every 15 minutes for the period of 3/2/2023 - 3/15/2023 to LPA via email: maryrose.breault@dss.ca.gov by 3/15/2023.
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This evidence is met by.... licensee unable to produce complete 15 minute check log of all infants 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: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 17-CC-20221219135413
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: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2023
Section Cited
HSC
1597.465
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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met....No more than three infants are cared for during any time when more than 12 children are being cared for.
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Licensee to review Large FCCH Ratio Sheet and submit in writing how she will maintain complaince at all times. Submit to LPA via email: maryrose.breault@dss.ca.gov by 3/15/2023.
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LPA observed one (1) school aged child, nine (9) day care children, five (5) infants
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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: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6