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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 243806059
Report Date: 07/25/2022
Date Signed: 07/25/2022 01:24:17 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/19/2022 and conducted by Evaluator Priscilla Zamudio
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20220719083844
FACILITY NAME:DANA'S DAY CAREFACILITY NUMBER:
243806059
ADMINISTRATOR:HAUMEA, DANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 769-1293
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:14CENSUS: 5DATE:
07/25/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Dana HaumeaTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Uncleared adult in the home during day care hours.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Priscilla Zamudio and Robert Gutierrez conducted an unannounced complaint inspection to gather information and investigate the above allegation. LPAs met with Licensee, Dana Haumea. Licensee accompanied LPAs during tour of facility both inside and outside. LPAs discussed the allegation and took a census. During todays inspection LPAs interviewed licensee, children and reviewed facility records.

Based on interviews conducted, it was determined that on an occassion an uncleared adult was providing care or supervision to a daycare child when the licensee was not present in the facility. Based upon observations and information gathered through interviews, the perponderance of evidence standard has been met, therefore, the above allegation is found to be substantiated.

Continued on 9099 - C

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022
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 04-CC-20220719083844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: DANA'S DAY CARE
FACILITY NUMBER: 243806059
VISIT DATE: 07/25/2022
NARRATIVE
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Per California Code of Regulations, Title 22, Division 12, Chapter 3, this deficiency is being cited on the attached LIC 9099D.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months." The licensee was provided a copy of the "Fact Sheet" for AB 633 (Parent Notification Requirements), along with a copy of the relevant documents this date. A completed signed copy of the LIC 9224 will be placed in each child's file.

An exit interview conducted with Licensee, Dana Haumea. A copy of this report and Appeal Rights were provided and discussed with Dana Haumea. Licensee was informed upper management shall review this matter to determine if a civil penalty shall be issued.

A Notice of Site Inspection Form was posted to parent's board and must remain posted for 30 days.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 04-CC-20220719083844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: DANA'S DAY CARE
FACILITY NUMBER: 243806059
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/25/2022
Section Cited
CCR
102370(a)
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Criminal Record Clearance. Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption. During interviews conducted it was determined an uncleared adult provided care for children in care while
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Licensee denies the allegation took place.
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Licensee was not present. This poses as an immediate risk to the health, safety or personal rights of 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: Diana deLeon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4