566207355-3-16-2023-17-CC-GMIE-CQF2AH-20230330171333

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 566207355
Report Date: 03/16/2023
Date Signed: 03/16/2023 01:57:42 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
03/10/2023 and conducted by Evaluator Susana Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 17-CC-20230310101429

FACILITY NAME:	CAMP AMGEN		FACILITY NUMBER:	566207355
ADMINISTRATOR:	JENNIFER MCHUGH		FACILITY TYPE:	850
ADDRESS:	855 VENTU PARK RD.		TELEPHONE:	(805) 447-6793
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91320
CAPACITY:	324	CENSUS: 108	DATE:	03/16/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	JENNIFER MCHUGH		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not ensure there is hot water available in faucets used for food services.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On March 16, 2023 at 10 AM, Licensing Program Analysts (LPA's) Susana Martinez and Giovani Gonzalez conducted an unnanounced inpsection for the purpose of initiating a complaint regarding the above mentioned allegation. LPA's met with Jennifer McHugh and advised her of the purpose for the inspection. Together with the director LPA's toured the facility inside and outside. At the time of inspection there were 108 children present along with 18 adults.

LPA's did not observe any toxins/hazourdous items during the inspection. LPA's asked director if she had any idea why licensing would be here. Director Jennifer stated no. As the inspection continued Jennifer stated she might have an idea. Jennifer states the complaint might be in regards to the water temprature. LPA's asked Jennifer to ellaborate.

Jennifer states there is construction on site, and a week ago the hot water stopped running in 2 pods labeled as the Caribou and Orca rooms. In total the affected rooms are 6. LPA's asked if there is a work order or proof that the hot water issue is being resolved. Jennifer provided a copy of the work order placed on 03/08/23, and shows a finish date of 05/01/23.
Continued on 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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-20230310101429

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: CAMP AMGEN	FACILITY NUMBER: 566207355
	VISIT DATE: 03/16/2023

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

LPA's observed the work order description stating to investigate/repair a slab leak and a broken line leaking into the room. LPA's advised director to ensure the leaks are not directly affecting the children in care. It was stated that there is no current alternative plan to provide hot water in the two rooms.

Based on LPA's observations, interviews which were conducted, documents gathered and record review, the preponderance of evidence standard has been met, therefore the above allegation is found SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 are being cited on the attached LIC 9099D.

Director will submit a written plan by 03/30/23 to the Department on what the center plans to use as an alternative during the time the hot water issue is resolved.

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 Licensee Jennifer Mc Hugh. A copy of the Appeal Rights (LIC 9058) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.

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

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 17-CC-20230310101429

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: CAMP AMGEN	FACILITY NUMBER: 566207355
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/16/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/30/2023 Section Cited CCR 101227(a)(22)(B)	1 2 3 4 5 6 7	Food Services 101227(a)(22)(B) In child care centers providing meals to children, the following shall apply:Equipment necessary for the storage, preparation and service of food or snacks shall be provided...equipment shall include, but not be limited to: Hot and cold running water. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director will submit a written plan to the Department on what the center plans to use as an alternative meanwhile the hot water issue is resolved. The estimated time of finish is 05/01/2023.
	8 9 10 11 12 13 14	Based on observation, interviews, and record review, Licensee admits 2 rooms do not have running hot water which poses a potential risk to the health, safety and or personal rights 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.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3