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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336300072
Report Date: 11/17/2023
Date Signed: 11/17/2023 10:21:06 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/14/2023 and conducted by Evaluator Jessica M Rubio
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20231114145056
FACILITY NAME:GOMES FAMILY CHILD CAREFACILITY NUMBER:
336300072
ADMINISTRATOR:SHERRYL GOMESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 504-4168
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY:14CENSUS: 7DATE:
11/17/2023
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Sherryl GomesTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Licensee operated out of ratio
INVESTIGATION FINDINGS:
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On November 17, 2023 at 8:35 am, Licensing Program Analyst (LPA) Jessica Rubio arrived unannounced to Gomes Family Child Care Home (FCCH) and met with LIcesnee Sherryl Gomes to initiate the complaint investigation regarding the allegation listed above. LPA Rubio conducted a census, reviewed records and interviewed licensee.

On November 14, 2023, a complaint was received alleging licensee operated out of ratio; specifically, that licensee is over ratio when operating without an assistant. LPA observed seven children (C1-C7) in care, three of whom were infants under two years old. The other four children were two and three year olds. There was no assistant present and licensee was the only person providing care. Licensee also disclosed there was one child (C8) who is usually present but was out sick on this day. C8 is also an infant under two years old. Licensee stated she does have an assistant, however the assistant was not present due to Licesnee believing two childen would be out sick. LPA reviewed children’s records and obtained birth dates for all children present.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
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 10-CC-20231114145056
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GOMES FAMILY CHILD CARE
FACILITY NUMBER: 336300072
VISIT DATE: 11/17/2023
NARRATIVE
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Licensee stated nine children are enrolled regularly and record review revealed nine children attend regularly and three additional drop in children are enrolled as well. LPA observed the facility to be operating out of ratio at this time.

Based on observation and record review conducted during the investigation, the preponderance of evidence standard has been met and the allegation that licensee operated out of ratio is substantiated. The facility is being cited for Title 22 Regulations Section 102416.5 (e) Staffing Ratio and Capacity. See LIC 9099-D for cited deficiencies.

An exit interview was conducted, appeal rights were discussed and provided to the licensee Sherryl Gomes along with a copy of this report. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20231114145056
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: GOMES FAMILY CHILD CARE
FACILITY NUMBER: 336300072
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/27/2023
Section Cited
CCR
102416.5(e)
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(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement was not met as evidenced by:
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Licensee stated she will write a statement that she understands and will adhere to the capacity/ratio requirement without an assistant and will turn away children if needed.
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Based on LPA observations of seven children in care, three of whom are infants with no assistant present, which poses a potential health, safety and/or personal rights risk to 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: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3