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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216426
Report Date: 08/20/2024
Date Signed: 08/20/2024 04:55:45 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
08/14/2024 and conducted by Evaluator Martina Jimenez
COMPLAINT CONTROL NUMBER: 17-CC-20240814103734
FACILITY NAME:SILVA MEDINA FAMILY CHILD CAREFACILITY NUMBER:
426216426
ADMINISTRATOR:ELIZABETH SILVA MEDINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 201-8992
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:14CENSUS: 10DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elizabeth Silva MedinaTIME COMPLETED:
04:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee has unpermitted construction being conducted
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/20/2024, at 1:30 PM, Licensing Program Analyst (LPA) Martina Jimenez, conducted an unannounced inspection of the Family Child Care Home (FCCH) to initiate a compliant investigation reference to the above allegation.

LPA met with Elizabeth Silva Medina, licensee, Laura Barajas, assistant and Cinthia Pineda Luna, assistant. LPA Jimenez explained the nature and purpose of the investigation. LPA observed two (2) infants, and eight (8) children napping at the time of the inspection.

The investigation included one (1) unannounced inspections, LPAs observation, interview with licensee, review of children's files, and, documents obtained during the inspection.

CONT LIC 9099-C, LIC 9099D
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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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