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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566214141
Report Date: 05/24/2022
Date Signed: 05/24/2022 12:23:59 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
04/28/2022 and conducted by Evaluator Austin Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20220428104306
FACILITY NAME:EASTER SEALS VENTURA CDCFACILITY NUMBER:
566214141
ADMINISTRATOR:REBECCA KLAMSERFACILITY TYPE:
850
ADDRESS:10730 HENDERSON ROADTELEPHONE:
(805) 647-1141
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY:122CENSUS: 61DATE:
05/24/2022
UNANNOUNCEDTIME BEGAN:
11:29 AM
MET WITH:Catherine RutledgeTIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Level of Care-Staff are not properly supervising children in care
Other-Child in care had access to hazardous materials
INVESTIGATION FINDINGS:
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On May 24, 2022 at 11:29 AM, Licensing Program Analyst (LPA) Austin Rios conducted an unannounced inspection to conclude a complaint investigation. LPA met with Site Supervisor Catherine Rutledge and explained the nature and the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were 61 children in care at the time of the inspection. The department obtained an allegation that Staff are not properly supervising children in care and Child in care had access to hazardous materials.

Interviews were conducted with Complainant, Parents of children in care, and staff. LPA obtained documentation regarding the incident of Child#1. On 4/26/2022. C#1 had in her mouth a thin bolt like small washer. LPA observed the washer during on site inspection that director kept in a plastic bag in the office. On 4/6/2022 C#1 had access to a black marker which was on her hands, lips, and teeth. Staff were present when the incident occurred.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
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-20220428104306
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: EASTER SEALS VENTURA CDC
FACILITY NUMBER: 566214141
VISIT DATE: 05/24/2022
NARRATIVE
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This agency has investigated the complaint alleging, Staff are not properly supervising children in care and Child in care had access to hazardous materials and based on interviews conducted and documentation obtained, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED.

Exit interview was conducted with director. The Notice of Site Visit (LIC9213) was posted. The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 17-CC-20220428104306
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: EASTER SEALS VENTURA CDC
FACILITY NUMBER: 566214141
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2022
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation.

This requirement is not met as evidenced by:
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Site Director agreed submit a written plan of correction (POC) stating measures to be taken in order to follow Title 22 Regulations and avoid another incident like this happening in the future by 6/24/2022.
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Based on staff interviews, C1 had a black marker on face, lips, and teeth, before staff noticed, which poses a potential health, safety or personal rights risk to persons in care.
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Type B
05/24/2022
Section Cited
CCR
101238(g)
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Buildings and Grounds
101238 (g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
This requirement was not met as evidence by:
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Facility will submit a written Plan of Correction on how they will prevent this from happening again to LPA Rios at austin.rios@dss.ca.gov by 6/24/2022. Facility will also partner with Ventura County Inclusion Program for further staff training.
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Based on observation and interviews C1 had access to a thin bolt like washer. This poses a potential health and safety 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: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3