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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216036
Report Date: 08/25/2023
Date Signed: 08/25/2023 01:28:33 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST-CHILD, 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
08/17/2023 and conducted by Evaluator Giovani Gonzalez
COMPLAINT CONTROL NUMBER: 17-CC-20230817144812
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: 3DATE:
08/25/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Maria Pantoja, Javier Guzman TIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Licensee is over ratio
INVESTIGATION FINDINGS:
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On Augsut 25th, 2023, Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced inspection to initiate and close a complaint. LPA me with Licensees Maria Pantoja and Javier Guzman and informed them the nature of the inspection. At the time of the inspection there were 3 children in care, and an assistant present.

During the tour of the home Licensee Maria Pantoja admitted that during a visit from Resources and Referrals (R&R) their assistant was left alone to care for 13 children. Licensee Maria Pantoja stated that she had stepped out briefly to buy milk when the the representative from R&R arrived to the the facility. Licensee Javier Guzman was also not in the home.

Based on LPA's interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 , are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023
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 2
Control Number 17-CC-20230817144812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/25/2023
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.

This requirement was not met evidence by:
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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: giovani.gonzalezt@dss.ca.gov by 9/8/2023.
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Licensees leaving their assistant alone caring for 13 children, 4 of which were infants which poses a pontential risk to the health and safety of chilren 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: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2