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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 426215188
Report Date: 08/31/2023
Date Signed: 08/31/2023 02:43:45 PM

Unsubstantiated


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
08/21/2023 and conducted by Evaluator Elvin Baddley
COMPLAINT CONTROL NUMBER: 17-CC-20230821091846
FACILITY NAME:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
426215188
ADMINISTRATOR:ALEJANDRA DIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 287-0854
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 9DATE:
08/31/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Alejandra DiazTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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1. Licensee is not residing at the facility.
INVESTIGATION FINDINGS:
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On 8/31/23, Licensing Program Analysts (LPAs) Elvin Baddley and German Negrete made an unannounced inspection to the abovementioned address to invesigate and dispose of an allegation related to the Licensee not residing at the facility.

LPAs met with Alejandra Diaz, Licensee of the Family Child Caqre Home (FCCH) and explained the nature and purpose of the inspection. LPAs toured the interior and exterior of the home in the company of the Licensee. LPAs observed 9 children in care at the time of the inspection along with three Assistants.

LPA's inspection of the home suggest the Licensee is the current occupant of the residence. LPAs observed personal indicia in each of the bedrooms and furnishing to suggest habitation. Further, LPAs observed Licensee and spouse exit at the home between the hours of 4:00 AM- 7:00 AM on 8/25/23.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove
(CONT.9099-C, Page 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
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 2
Control Number 17-CC-20230821091846
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: DIAZ FAMILY CHILD CARE
FACILITY NUMBER: 426215188
VISIT DATE: 08/31/2023
NARRATIVE
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the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A Notice of Site Visit (LIC 9213) and Appeal Rights (LIC 9058) were provided to the Licensee The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00 may apply.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2