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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 093616621
Report Date: 11/14/2025
Date Signed: 11/14/2025 10:17:35 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/22/2025 and conducted by Evaluator Andrea Cortez
COMPLAINT CONTROL NUMBER: 03-CC-20250822132356
FACILITY NAME:GREEN VALLEY PRESCHOOLFACILITY NUMBER:
093616621
ADMINISTRATOR:GARCIA, SUSANFACILITY TYPE:
850
ADDRESS:2380 BASS LAKE ROADTELEPHONE:
(530) 295-4526
CITY:RESCUESTATE: CAZIP CODE:
95672
CAPACITY:21CENSUS: 10DATE:
11/14/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Susan GarciaTIME COMPLETED:
10:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights
Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Andrea Cortez met with Site Supervisor Susan Garcia, to deliver findings regarding the above allegations. Upon arrival LPA observed children during floor time and table activities. LPA observed: 10 children supervised by 4 staff members.

During complaint investigation, LPA made observations, gathered documents, and conducted interviews. Throughout investigation, there was insufficient evidence to support allegations listed above.

Although the allegations may have happened, there is not a preponderance of evidence to prove the allegations; therefore, the allegations are unsubstantiated. Exit interview was conducted and report was reviewed with Site Supervisor Susan Garcia. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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