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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304312725
Report Date: 10/11/2021
Date Signed: 10/11/2021 02:20:42 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/04/2021 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20211004173828
FACILITY NAME:GALVIN-REYES, COLLEENFACILITY NUMBER:
304312725
ADMINISTRATOR:GALVIN-REYES, COLLEENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 466-7977
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:14CENSUS: 10DATE:
10/11/2021
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Galvin-Reyes, ColleenTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Licensee is opearting over ratio.
Day care children are left unsupervised while in care.
INVESTIGATION FINDINGS:
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A complaint inspection was conducted at the facility by Licensing Program Analyst (LPA) Cindy Nguyen, in response to the above allegations. Met with licensee, Galvin-Reyes, Colleen who guided analyst on a tour of the facility. Present at the time of the inspection was the licensee, and 10 day care children, 4 of which were under the age of two years. At 11:23 am, LPA observed Child #1 napping on a mat inside in the living room, and 9 other children playing outside in the back yard. During today’s investigation the facility was operating out of ratio. A review of adults living or working in the home on this date indicated individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 10/04/21 a complaint was filed with the Licensing Office. Complainant alleged the facility is operating over ratio and day care children are left unsupervised while in care.

Continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
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 06-CC-20211004173828
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GALVIN-REYES, COLLEEN
FACILITY NUMBER: 304312725
VISIT DATE: 10/11/2021
NARRATIVE
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Page 9099C

During today's inspection, a physical plant inspection was conducted, interviewed licensee, and obtained a copy of the children's roster. Licensee stated her assistant left her job with the facility suddenly and Licensee has been getting helps from her part time staff here and there, but not today. Licensee stated she has hired an assistant but waiting for the paperwork to be completed. At 11:35am, during the transition from the outdoor to the indoor for lunch, LPA observed a child napping in the living room, a child in the restroom with the licensee, 7 children were sitting on the carpet, and Child #5 was outside playing by himself in the back yard. Based on LPA observations which were conducted and review of the roster to verify the age of each child in care, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. California Code of Regulations, 102416.5 and 102417 (a) are being cited on the attached LIC 9099D.

This report cite Type A violations and shall be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

An exit interview was conducted with Licensee, Galvin-Reyes, Colleen. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20211004173828
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GALVIN-REYES, COLLEEN
FACILITY NUMBER: 304312725
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/11/2021
Section Cited
CCR
102416.5
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Staffing Ratio and Capacity. For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, ...licensee's home and the assistant provider's children under age 10, shall be either: This requirement is not met as evidenced by:
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During the visit, licnesee called parents to pick up some of the children and plans to called for helps or not have the children come unless licensee gets an assistant.
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Based on observation, interview and record review, the licensee failed to ensure to keep the maximum number of children in care at one time when an assistant is not present. This poses an immediate Health and Safety risk to the children in care.
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Type A
10/11/2021
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times.......This requirement is not met as evidenced by:
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Licensee will have an assistant here all the times, or will have less children at the facility.
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Based on observation, interview and record review, the licensee failed to ensure Child #5 was within licensee supervision. This poses an immediate Health and Safety risk to the 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: Judy Hanson
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3