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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 185406958
Report Date: 11/08/2023
Date Signed: 11/29/2023 11:54:17 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/15/2023 and conducted by Evaluator Sydney Sims
COMPLAINT CONTROL NUMBER: 13-CC-20230815104930
FACILITY NAME:EIGEN, SALLY FAMILY CHILD CARE HOMEFACILITY NUMBER:
185406958
ADMINISTRATOR:EIGEN, SALLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 640-2034
CITY:SUSANVILLESTATE: CAZIP CODE:
96130
CAPACITY:14CENSUS: 9DATE:
11/08/2023
UNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Sally Eigen TIME COMPLETED:
01:38 PM
ALLEGATION(S):
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Staff Flicked Child
INVESTIGATION FINDINGS:
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On November 08, 2023 at 1:10pm, Licensing Program Analyst (LPA) Sims conducted an unannounced complaint inspection, and met with licensee Sally eigen. It was alleged that staff flicked a child in care.
The licensee was interviewed on August 22, 2023, and denied that the staff do not flick children.
1 staff (S1) was interviewed on August 22, 2023, and admitted that S1 sometimes flicks children in care, and has pinched a child (C1) while in care while they were in care.

During today’s inspection facility LPA Sims met with Licensee Sally Eigen and delivered a comlaint investigation.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.

LPA S. Sims informed licensee Sally Eigen that this report dated 11/08/23 documents 1 Type A citation(s) which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA S. Sims informed the licensee to provide a copy of this licensing report dated 11/08/23 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Sydney Sims
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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 2
Control Number 13-CC-20230815104930
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: EIGEN, SALLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 185406958
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/09/2023
Section Cited
CCR
102423(a)(4)
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Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
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Licensee and Assistant to watch training videos from CCL website provided by LPA Sims. Licensee will send document stating that all staff have watched the video and what they learned from the video. Statement is to be signed and dated by all employees.
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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation...
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Licensee will have all parents with currently enrolled children sign the LIC 9224 and all parents who enroll for the next 12 months sign the LIC 9224
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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: Megan Aviles
LICENSING EVALUATOR NAME: Sydney Sims
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2