<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 093623234
Report Date: 03/08/2024
Date Signed: 03/08/2024 10:46:23 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
02/20/2024 and conducted by Evaluator Soleil Marx
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240220112750
FACILITY NAME:PINE TOP INFANT & TODDLER CENTER (PS)FACILITY NUMBER:
093623234
ADMINISTRATOR:JILL KIMEFACILITY TYPE:
850
ADDRESS:5723 PONY EXPRESS COURTTELEPHONE:
(530) 391-2604
CITY:POLLOCK PINESSTATE: CAZIP CODE:
95726
CAPACITY:14CENSUS: 5DATE:
03/08/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Irene GreenTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide a safe and comfortable environment for daycare children
Staff are not properly supervising daycare children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Soleil Marx met with Facility Representative, Irene Green, for the purpose of conducting an unannounced consecutive complaint investigation inspection to deliver findings for the above allegations. The purpose of today's inspection was explained.

Throughout the course of investigation, LPA made observations of teacher/child interactions, classroom management, facility environment, reviewed relevant documentation, and conducted interviews with staff and authorized representatives. LPA observed the facility to be clean, orderly, and in good repair. LPA observed hazardous items are inaccessible to children in care. LPA observed classroom and activity spaces have open floor plans to easily maintain visual supervision. LPA determined that staff maintain supervision by spacing out, being attentive and responsive to children in care, keeping children engaged with small group activities, and doing name to face counts during transitions. LPA reviewed incident reports which documented normal childhood incidents/injuries and contained explanation of occurance. Parent interviews did not reveal concerns that would collaborate with the allegations.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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 2
Control Number 03-CC-20240220112750
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PINE TOP INFANT & TODDLER CENTER (PS)
FACILITY NUMBER: 093623234
VISIT DATE: 03/08/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA did not obtain any pertinent evidence through observation, record review, or interview during the investigation to prove that staff did not provide a safe and comfortable environment for daycare children or that staff are not properly supervising daycare children. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

Exit interview and report reviewed with Facility Representative, Irene Green. Appeal rights were provided. No citations were issued.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2