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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566214036
Report Date: 02/10/2023
Date Signed: 03/08/2023 02:21:50 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
11/23/2022 and conducted by Evaluator Laura Villanueva
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20221123150242
FACILITY NAME:SHINING STARS PRESCHOOL & INFANT CENTERFACILITY NUMBER:
566214036
ADMINISTRATOR:ARMIDA LUEVANOFACILITY TYPE:
830
ADDRESS:2480C E. LAS POSAS RD.TELEPHONE:
(805) 987-2132
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY:35CENSUS: 10DATE:
02/10/2023
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Armida LuevanoTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Day care child sustained a rash while in care.
INVESTIGATION FINDINGS:
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On February 10, 2023 at 01:30 PM Licensing Program Analyst (LPA) Laura Villanueva conducted an unannounced inspection to conclude the investigation for the allegation above. LPA met with Director, Armida Luevano and explained the purpose for the inspection. LPA asked pre-screening questions related to COVID-19. Responses suggest no COVID exposure on site. LPA conducted a tour of the facility inside and outside with Director. LPA observed 10 children and 3 staff present at the time of the inspection.

Director informed LPA that the child developed a rash after a bottle feeding. The child is fed breast milk provided by his mother while in care. Staff unsure of the number of times the child developed a rash while in care. Child's parents were verbally informed of the rash. The child was taken to a doctor for an evaluation. It was determined child is allergic to cow's milk, and develops a rash when in contact. There is no evidence of what caused the child's rash at the child care center. A picture was taken of the child showing the rash on his face. No follow-up to the rash was completed on the part of the staff. No deficiencies cited under Title 22 Division 12.

Continued on LIC9099C


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
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 17-CC-20221123150242
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: SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 566214036
VISIT DATE: 02/10/2023
NARRATIVE
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A picture was taken of the child showing the rash on his face. No follow-up to the rash was completed on the part of the staff.

Substantiated – “Based on LPAs observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number).

An advisory note was given advising center staff to assure that the all enrollment documentation is completed and reviewed before child begins attending center. The documentation that is completed for possible food allergies is shared with all the staff that works with children with an allergy.

Exit interview conducted with Director, Armida Luevano. A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Director’s signature on this form acknowledges receipt of these rights.

The Notice of SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY. THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20221123150242
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: SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 566214036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
HSC
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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: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3