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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566216213
Report Date: 09/12/2024
Date Signed: 09/12/2024 04:52:30 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 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
04/30/2024 and conducted by Evaluator Susana Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20240430144644
FACILITY NAME:FLORES FCC AKA KOODAKAN DAYCAREFACILITY NUMBER:
566216213
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
09/12/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Erika FloresTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Licensee does not ensure care and supervision is provided to children in care.
Licensee left children in the facility unattended.
INVESTIGATION FINDINGS:
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On September 12, 2024 Licensing Program Analyst's (LPA's) Susana Martinez and David Roman conducted an unannounced inspection to deliver the findings of the above mentioned allegations. LPA's met with Licensee, Erika Flores and advised her of the purpose for the inspection. Together with the Licensee, LPA's toured the facility inside and outside. At the time of inspection there were no children in care and only three adults in the home.

The investigation included two unannounced inspections, LPAs' observations and record reviews, as well as interviews (random sampling) of current parents of children in care. Interviews and LPAs' observations did not corroborate the allegations noted above. In essence, investigations revealed the Licensee does not leave children in the facility unattended and Licensee ensures care and supervision is provided to children in care. Parents interviewed felt content with the level of care and supervision their children receive. Additionally, parents did not have any concerns regarding the Licensee. Parents indicated children have not complained.
Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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 2
Control Number 17-CC-20240430144644
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: FLORES FCC AKA KOODAKAN DAYCARE
FACILITY NUMBER: 566216213
VISIT DATE: 09/12/2024
NARRATIVE
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Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiencies were issued during this inspection.

A Notice of Site Visit (LIC 9213) and Appeal Rights (LIC 9058) were provided to Licensee. The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with Licensee, Erika Fores.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2