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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566206478
Report Date: 10/11/2022
Date Signed: 10/11/2022 05:23:40 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
08/15/2022 and conducted by Evaluator Michael Mathew
COMPLAINT CONTROL NUMBER: 17-CC-20220815115510

FACILITY NAME:KISSICK FCC AKA CAMP KISSICKFACILITY NUMBER:
566206478
ADMINISTRATOR:BRENDA I. KISSICKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 373-1486
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:14CENSUS: 8DATE:
10/11/2022
UNANNOUNCEDTIME BEGAN:
02:56 PM
MET WITH:Brenda kissickTIME COMPLETED:
05:35 PM
ALLEGATION(S):
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Licensee yelled at day care children.
Licensee does not properly supervise day care children.
INVESTIGATION FINDINGS:
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On 10/11/22 at 2:56 PM, Licensing Program Analyst (LPA) Michael Mathew conducted an unannounced inspection to conclude a complaint investigation and completed a COVID-19 pre-screening questions prior to entering the facility. LPA met with licensee Brenda Kissick. and advised her the purpose of the inspection. Licensee provided LPA a tour of the facility inside and out. There were 8 children and 2 staff in care at the time of the inspection.

Allegation were: Licensee yelled at day care children. Licensee does not properly supervise day care children. LPA conducted two unannounced inspection touring the facility inside and out during this investigation and did not observe any title 22 violations. LPA also conducted interviews with staff, parents, and neighbors. Parents that where interviewed stated that Licensee does not yell at the child. Neighbors that where interviewed stated that they have heard a loud voice but does not know who it was. Neighbor also stated that they have seen children playing without supervision. Parents that were interviewed stated that they have seen Licensee, licensee’s daughter and son supervising the children,
Cont. 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 17-CC-20220815115510
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: KISSICK FCC AKA CAMP KISSICK
FACILITY NUMBER: 566206478
VISIT DATE: 10/11/2022
NARRATIVE
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LPA have observed Adequate supervision from licensee and and her assistant, LPA also did not observed any yelling from licensee.

This agency has investigated the complaints alleging "Licensee yelled at day care children and Licensee does not properly supervise day care children. " Based on the evidence, the Department has determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

"No deficiency were cited on todays visit"

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were given, and report was reviewed with licensee Brenda Kissick

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/11/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4