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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216444
Report Date: 06/05/2025
Date Signed: 06/05/2025 11:51:24 AM

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
03/11/2025 and conducted by Evaluator Giovani Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20250311143828
FACILITY NAME:MICHEL FAMILY CHILD CAREFACILITY NUMBER:
426216444
ADMINISTRATOR:YESENIA MICHELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 458-9327
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 5DATE:
06/05/2025
UNANNOUNCEDTIME BEGAN:
11:09 AM
MET WITH:Yesenia MichelTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Personal Rights - Provider left day care child unattended.
INVESTIGATION FINDINGS:
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On June 5, 2025 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced inspection at the above-mentioned Family Child Care Home (FCCH) . LPA met with licensee Yesenia Michel and informed them the purpose of the inspection. At the time of the inspection 5 children were present.

The investigation included 2 inspections, record review and interviews. The allegation of Personal Rights - Provider left day care child unattended was corroborated. An interview with the licensee revealed Child 1 (C!) was left unattended by the provider at Child 2's (C2) elementary school. Further, an interview with Adult (A1) revealed C1 went to the elementary school's office stating they were left behind by their baby sitter. LPA reviewed journal entries from the Santa Maria Police Department which corroborated the child was left unattended as well.


CONTINUED PAGE 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
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 3
Control Number 17-CC-20250311143828
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: MICHEL FAMILY CHILD CARE
FACILITY NUMBER: 426216444
VISIT DATE: 06/05/2025
NARRATIVE
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Based on LPAs observations, interviews which were conducted, documents gathered and/or record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 or Health and Safety Code, are being cited on the attached LIC 9099D.

Upon receipt, provide copies of this licensing report to each parent/guardian of enrolled children and to parents/guardians of newly enrolled children during the next 12 months. Acknowledgement of Receipt LIC 9224 form shall be used for this purpose. LIC 9224 after completed shall be maintained in each child's file. (LIC 9224 was provided to Licensee).

Report was reviewed with licensee Yesenia Michel and notice of site visit was given. Appeal Rights were given.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20250311143828
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: MICHEL FAMILY CHILD CARE
FACILITY NUMBER: 426216444
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/05/2025
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home

The licensee shall be present in the home and shall ensure that children in care are supervised at all times.
This requirement is not met evidenced by:
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Licensee will submit a statement outlining how they will ensure future incidents do not occur. Licensee will submit statement to LPA via email at giovani.gonzalez@dss.ca.gov.
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Based on interviews conducted and record review C1 was left without supervision which poses an immediate risk to the health, safety and or personal rights of children 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: 06/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3