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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566215335
Report Date: 04/21/2023
Date Signed: 04/21/2023 02:00:04 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
01/30/2023 and conducted by Evaluator Laura Villanueva
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20230130131436
FACILITY NAME:FUSD - SESPE PRE SCHOOLFACILITY NUMBER:
566215335
ADMINISTRATOR:LORENA RAMOSFACILITY TYPE:
850
ADDRESS:627 SESPE AVETELEPHONE:
(805) 524-8202
CITY:FILLMORESTATE: CAZIP CODE:
93015
CAPACITY:48CENSUS: 46DATE:
04/21/2023
UNANNOUNCEDTIME BEGAN:
09:51 AM
MET WITH:Lorena RAmosTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Child in care sustained unexplained bruising
INVESTIGATION FINDINGS:
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On April 21, 2023 at 9:51 AM Licensing Program Analyst (LPA) Laura Villanueva made an unannounced inspection to conclude the investigation for the allegation. LPA met with Program Director, Lorena Ramos and explained the purpose of the inspection. LPA conducted a tour of the facility inside and outside. LPA observed a total of 46 children under the care and supervision of 9 staff.

LPA interviewed Program Director, staff, and parents. The mothers of C1, C3, and C5 disclosed that their child has sustained injuries that staff were not able to explain. C3 has sustained unexplained injuries on 2 occasions. Staff stated to parents that they were not aware of the injury that occurred under their care. Parents spoke and met with Program Diirector and Teachers about their concerns. The injuries were reported to the Department and a witten LIC624 unusual incident/injury report.

Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
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 3
Control Number 17-CC-20230130131436
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: FUSD - SESPE PRE SCHOOL
FACILITY NUMBER: 566215335
VISIT DATE: 04/21/2023
NARRATIVE
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Based on LPA observations, interviews conducted with staff /parents and documentation, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. A type A violation was issued in section Responsibility for care and supervision 101229(a)(1). Today, deficiency is cited under Title 22 Division 12. Appeal rights given.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

Copies of this report must be posted for 30 days in a visible location for the authorized representatives of children. Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with Program Administrator. A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Program Director's signature on this form acknowledges receipt of these rights.

LPA issued a citation for lack of care and supervision while the children are in attendance. A type A violation was issued in section Responsibility for care and supervision 101229(a)(1). Today, deficiency cited under Title 22 Division 12. Appeal rights given. The following deficiency is being cited in accordance to Title 22 of the California Code of Health & Safety. Please refer to LIC9099D OR LIC809D for documentation of deficiencies cited:
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 17-CC-20230130131436
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: FUSD - SESPE PRE SCHOOL
FACILITY NUMBER: 566215335
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/21/2023
Section Cited
HSC
1012289(a)(1)
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101229 Responsibility for Providing Care and Supervision-(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision...shall include visual observation.
This requirement was not met as evidenced by:
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Program Director is having a staff meeting today to address care and supervision concerns. A plan will be created and reviewed with staff.
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Children sustaining unexplained injuries while under the care and supervision of staff. Three confirmed incidents which staff are not aware of injuries. These incidents are an immediate health and safetey concern for all 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: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3