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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070206070
Report Date: 06/02/2022
Date Signed: 06/02/2022 10:23:12 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/09/2022 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20220309100454
FACILITY NAME:KING'S VALLEY PRESCHOOLFACILITY NUMBER:
070206070
ADMINISTRATOR:KETNER, MICHELEFACILITY TYPE:
850
ADDRESS:4255 CLAYTON ROADTELEPHONE:
(925) 687-2020
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:120CENSUS: 0DATE:
06/02/2022
UNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Michelle KetnerTIME COMPLETED:
10:33 AM
ALLEGATION(S):
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Day care is out of ratio
INVESTIGATION FINDINGS:
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On 6/2/22 at 9:22AM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced to deliver the findings to the above complaint allegation. LPA met with Director Michelle Ketner. During the course of the investigation LPA Fernandes conducted interviews and reviewed documents pertaining to the complaint.

According to the center's records on 2/28/22 there were 47 children present after 3PM with only three teachers and one teacher's aide, however the Director stated she was present during the time but there are no records to confirm. Based on an interview with Director Ketner there was an incident where a teacher was left with 13 children for a short period of time making the classroom out of ratio. Therefore the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. Title 22, is being cited on the attached LIC. 9099D.

Appeal Rights were discussed
An exit interview was conducted
Report, Appeal Rights and notice of site visit was provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
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 02-CC-20220309100454
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KING'S VALLEY PRESCHOOL
FACILITY NUMBER: 070206070
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/16/2022
Section Cited
CCR
101216.101216.3
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Teacher-Child Ratio- There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance. This requirement has not been met as evidenced by:
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The center will come up with a plan to ensure the ratio requirements are always met and to include classroom changes. Then send the plan to CCL by proof of correction date.
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Based on conformation from Director Michelle Ketner a teacher was supervising 13 children, which can pose a potential risk to child 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: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/09/2022 and conducted by Evaluator Catherine Fernandes
COMPLAINT CONTROL NUMBER: 02-CC-20220309100454

FACILITY NAME:KING'S VALLEY PRESCHOOLFACILITY NUMBER:
070206070
ADMINISTRATOR:KETNER, MICHELEFACILITY TYPE:
850
ADDRESS:4255 CLAYTON ROADTELEPHONE:
(925) 687-2020
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:120CENSUS: DATE:
06/02/2022
UNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Michelle KetnerTIME COMPLETED:
10:33 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are rough with children in care
INVESTIGATION FINDINGS:
1
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3
4
5
6
7
8
9
10
11
12
13
On 6/2/22 at 9:22AM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced to deliver the findings to the above complaint allegation. LPA met with Director Michelle Ketner. During the course of the investigation LPA Fernandes conducted interviews and reviewed documents pertaining to the complaint.

There was an allegation made that Director Ketner and a staff member is rough with the children in care however interviews indicated conflicting information. Therefore allegation is UNSUBSTANTIATED, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur at the fault of the day care.

Appeal Rights were discussed
An exit interview was conducted
Report, Appeal Rights and notice of site visit was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
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 3