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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426216596
Report Date: 11/06/2024
Date Signed: 11/06/2024 01:51:57 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
11/04/2024 and conducted by Evaluator Martina Jimenez
COMPLAINT CONTROL NUMBER: 17-CC-20241104101351
FACILITY NAME:GARCIA FCCHFACILITY NUMBER:
426216596
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
11/06/2024
UNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Guadalupe GaciaTIME COMPLETED:
10:48 AM
ALLEGATION(S):
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Licensee is caring for 15 children at a time.
INVESTIGATION FINDINGS:
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On 11/06/2024, at 7:30 AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced inspection of the Family Child Care Home (FCCH) to initiate the investigation of the above allegation. LPA met with Guadalupe Gacia, licensee and Miguel Pena-Escobar, assistant/husband. LPA explained the purpose of the inspection. LPAs observed six (6) children in the home at the time of the inspection.

Upon the arrival to the home LPA rang the door bells, and knocked on the door several times. LPA called the licensee and left a voicemessage informing the licensee LPA was at the door. At 7:40 AM, LPA received a call from the licensee stating she was walking to the home from dropping off children at school, and approximately three (3) minutes later LPA observed the licensee walking to the home.


Continues on LIC9099C & LIC9099D

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
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 4
Control Number 17-CC-20241104101351
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: GARCIA FCCH
FACILITY NUMBER: 426216596
VISIT DATE: 11/06/2024
NARRATIVE
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LPA informed the licensee that LPA has been knocking and rang the doorbell several times, with no response. Once inside the home LPA observed the gate to the stairs was open, the assistant in the home with seven (7) children and four (4) of the children were licensee's own children, which one of the children is over the age of ten years old.

At 7:49 AM, LPA observed C1 open the safety gate to the stairs, go upstairs and return back downstairs at 7:51 AM. At 7:53 AM, C1 once again open the safety gate went back upstairs and returned downstairs at 7:55 AM.

LPA with the licensee toured the interior and exterior of the home, including the second story of the home. LPA observed in bedroom #1, #2, & #3 the following items; Body power, personal hygiene products (cleaner, toner, lotions, perfumes, pain mediations, deodorants, ect..) and bedroom #4 was secured at the time of the inspection.

LPA interviewed the Licensee regarding allegation. The licensee informed LPA in the mornings licensee cares for nine (9) children, which include three (3) children licensee had just dropped off at school. Licensee also informed LPA that in the afternoon licensee cares for twelve (12). The licensee informed LPA three (3) children are left with assistant, the licensee goes to three (3) different schools and picks up a total of nine (9) children, dropping off six (6) children at their homes and returning to the home with three (3) children.

Continues on LIC9099C & LIC 9099D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 17-CC-20241104101351
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: GARCIA FCCH
FACILITY NUMBER: 426216596
VISIT DATE: 11/06/2024
NARRATIVE
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The investigation included one (1) unannounced inspections, LPA observation, review of children's files, roster, documents obtained during the inspection and interview with licensee revealed FCCH is operating over capacity.

Today’s visit was conducted in Spanish by LPA Jimenez. This report was translated in Spanish by LPA Jimenez. Today, deficiency cited under Title 22 Division 12, Spanish Appeal rights provided to licensee.

Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 9099 and LIC 9099 D.

LPA provided the Licensee a Notice of Site (LIC 9213) visit which was posted in the LPA's presence. this REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 17-CC-20241104101351
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: GARCIA FCCH
FACILITY NUMBER: 426216596
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/07/2024
Section Cited
CCR
102416.5(b)(3)
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(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following: (3) More than six and up to eight children, without an additional adult attendant, only if the criteria in Section 1597.44 of the Health and Safety Code are met. This requirement is not met as evidenced by:
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Licensee will submit a written POC on how licensee will prevent future incidents from occurring to CCLD by 11/7/2024, via email: Martina.Jimenez@dss.ca.gov
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 LPA observation, review of children's files, documents obtained during the inspection and interview with licensee revealed FCCH is operating over capacity. This poses an immediate risk to health, safety or personnel rights of persons 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: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4