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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 406212735
Report Date: 11/10/2022
Date Signed: 11/10/2022 05:16:00 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
10/14/2022 and conducted by Evaluator Gigi Reyes
COMPLAINT CONTROL NUMBER: 17-CC-20221014140031
FACILITY NAME:ZARATE FCC AKA RISING STARS CHILD CAREFACILITY NUMBER:
406212735
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
11/10/2022
UNANNOUNCEDTIME BEGAN:
02:41 PM
MET WITH:Martha ZarateTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Child sustained unexplained injuries while in care
INVESTIGATION FINDINGS:
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On 11/10/2022 at 2:41 PM, Licensig Program Analyst (LPA) Gigi Reyes conducted an unannounced inspection to conclude the investigation on the above complaint allegations. LPA met with Licensee and explained the purpose of the inspection. LPA asked pre screening questions related to COVID-19, Licensees responses there are no COVDI-19 exposure on site. There were 5 children present during the inspection.

Regarding the allegation, child sustained unexplained injury, report stated that licensee may have been frustrated with the child's behavior and grabbed C1 hard that caused the bruising on the child's thigh. LPA interviewed parents of currently and previously enrolled children, none of the parents interviewed corroborated with the allegation. On 10/19/2022, LPA interviewed Licensee who stated that Licensee did not see the bruise when Licensee changed C1's diaper at 11:00 AM on 9/30/2022. However, licensee stated that on or around 12:00 PM, three (3) children were riding the plasma car and bumping into each other, afterwards when children already went inside, C1 was complaining that C1 had "owie" .
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
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 3
Control Number 17-CC-20221014140031
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: ZARATE FCC AKA RISING STARS CHILD CARE
FACILITY NUMBER: 406212735
VISIT DATE: 11/10/2022
NARRATIVE
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 Licensee failed to check where was C1's "owie." Licensee was also skeptical if the bruise may have caused by children bumping into each other while riding the plasma car.

Based on LPA's observation, interview conducted, review of documentation and photos obtained, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED.


Exit interview conducted and report was reviewed with Licensee, Martha Zartae. A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.

The following deficiency being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC9099D for documentation of deficiency cited:

Notice of Site Visit was posted. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 17-CC-20221014140031
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: ZARATE FCC AKA RISING STARS CHILD CARE
FACILITY NUMBER: 406212735
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2022
Section Cited
CCR
102423(a)(2)
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102423 (a)(2) Personal Rights

(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:

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Licensee agreed to submit the plan of correction to Community Care Licensing no later thatn 11/18/2022. gigi.reyes@dss.ca.gov
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Based on LPA's interview with Licensee, Licensee failed to check where was C1's "owie" when C1 complained about getting hurt. Licensee was also skeptical if the bruise may have caused by children bumping into each other while riding the plasma car. This poses a potential risk to health and safety of chldren
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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: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3