<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566208586
Report Date: 02/11/2022
Date Signed: 02/11/2022 02:23:24 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
11/09/2021 and conducted by Evaluator Sylvia Mendoza-Ceja
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20211109090924
FACILITY NAME:THREE ANGELS PRESCHOOL AND INFANT CENTERFACILITY NUMBER:
566208586
ADMINISTRATOR:MARY WIGGINSFACILITY TYPE:
850
ADDRESS:6300 TELEPHONE RD.TELEPHONE:
(805) 639-0363
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:56CENSUS: 42DATE:
02/11/2022
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Mary WigginsTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights: Staff pulled a child's hair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On February 11, 2022 at 1:05PM, Licensing Program Analyst (LPA) Sylvia Mendoza-Ceja conducted an unannounced inspection to conclude a complaint investigation. LPA met with Director Mary Wiggins and explained the nature and the purpose of the inspection. Director provided LPA a tour of the facility inside and out. Investigation included obtaining the child care roster, interviewing the parents of children in care, current/former staff, and records review.

-Parents interviewed stated they are satisfied with the care and supervision their children receive.
-Staff interviewed revealed there was an incident that occurred when staff #2 violated the personal rights of two day care children by pulling/tugging on their hair for pulling the leaves off of a tree. One of the children informed two other staff about the "hair pulling". The staff confirmed with staff #2 about the hair pulling incident who acknowledged the incident occurred. Staff #2 then informed the Director about what had occurred. Director directed staff #2 to work late and to speak with the parents of the child #6 and child #7 to explain the incident. Staff #2 informed parent of child #6 and child #7 of the incident and apologized. On 2/8/2022, Director submitted an incident report and a statement signed by staff #2 indicating the incident occurred on 10/26/2021.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
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-20211109090924
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: THREE ANGELS PRESCHOOL AND INFANT CENTER
FACILITY NUMBER: 566208586
VISIT DATE: 02/11/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on LPA interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation, staff pulled a child's hair is found to be SUBSTANTIATED. California Code of Regulations, is cited on the attached LIC 9099D.

An exit interview was conducted, and Plan of Correction was reviewed and developed with the Director. A copy of this report and appeal rights were discussed and left with the Director.
LPA observed the Notice of Site Visit posted.


Upon receipt, post and provide copies of this licensing report: to parents/guardians of children in care at the facility and to parents/guardian of children newly enrolled at the facility during the next 12 months. Licensee shall obtain signatures of parents/guardian on the Acknowledgement of Receipt of Licensing Reports LIC 9224.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 17-CC-20211109090924
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: THREE ANGELS PRESCHOOL AND INFANT CENTER
FACILITY NUMBER: 566208586
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/14/2022
Section Cited
CCR
101223(a)(3)
1
2
3
4
5
6
7
Personal Rights: The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
1
2
3
4
5
6
7
Correct Immediately.
Please submit a plan of correction to Licensing for review by 02/14/2022.
8
9
10
11
12
13
14
This violation was evidenced by:

Based on interviews and record review which revealed staff #2 inappropriately disciplined child #6 and child #7 by pulling on their hair as a form discipline. This poses an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
11/09/2021 and conducted by Evaluator Sylvia Mendoza-Ceja
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20211109090924

FACILITY NAME:THREE ANGELS PRESCHOOL AND INFANT CENTERFACILITY NUMBER:
566208586
ADMINISTRATOR:MARY WIGGINSFACILITY TYPE:
850
ADDRESS:6300 TELEPHONE RD.TELEPHONE:
(805) 639-0363
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:56CENSUS: 42DATE:
02/11/2022
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Mary WigginsTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not prevent inappropriate behaviors between day care children
Staff did not notify day care children's authorized representatives regarding incidents
Staff scream at day care children
Day care children sustained injury while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On February 11, 2022 at 1:05PM Licensing Program Analyst (LPA) Sylvia Mendoza-Ceja conducted an unannounced inspection to conclude a complaint investigation. LPA met with Director Mary Wiggins and explained the nature and the purpose of the inspection. Director provided LPA a tour of the facility inside and out. Investigation included obtaining complainant's statement, interviewing the parents of children in care, current/former staff, and staff record review.

-Complainant alleged the above allegations. LPA attempted contact to complainant and left messages for additional information; however, complainant did not respond to LPA's requested for a return call.
-Parents interviewed stated they are satisfied with the care and supervision their children.
-Staff interviewed did not corroborate the above allegation.
-LPA could not corroborate the above allegations based on observations and interviews conducted with staff and parents. Although this allegation may have occurred, there is not a preponderance of evidence to prove that the alleged violations did or did not occur, therefore, the allegation listed above is deemed Unsubstantiated. Appeal Rights were reviewed and exit interview was conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4