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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313620289
Report Date: 08/28/2025
Date Signed: 08/28/2025 02:09:30 PM

Substantiated


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
07/02/2025 and conducted by Evaluator Mandie Goodwin
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250702160050
FACILITY NAME:O'BRIEN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
313620289
ADMINISTRATOR:KOENIG, DANOLDFACILITY TYPE:
850
ADDRESS:4035 GRASS VALLEY HWY, STE KTELEPHONE:
(530) 885-0530
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:32CENSUS: 7DATE:
08/28/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Patricia PerezTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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9
Staff did not have access to children's emergency contact information
INVESTIGATION FINDINGS:
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On August 28th, 2025 Licensing Program Analysts (LPAs) Mandie Goodwin and Lea Habtom met Director Patricia Perez to close a complaint investigation regarding the above allegations. Upon arrival 7 preschool children were present supervised by 2 staff members.

LPAs interviewed director who stated that there was a day when the facility was forced to close due to low staffing. Director stated that she, the owner, and a staff member called the parents to pick up their children, but there were some children that they could not locate emergency contact information for.

Based on interview conducted the preponderance of evidence standard has been met; therefore, the above allegations are substantiated. An exit interview was conducted and a notice of site visit provided. Notice of site visit shall remain posted for 30 days.

See LIC 9099-D for deficiencies.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
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
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
07/02/2025 and conducted by Evaluator Mandie Goodwin
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250702160050

FACILITY NAME:O'BRIEN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
313620289
ADMINISTRATOR:KOENIG, DANOLDFACILITY TYPE:
850
ADDRESS:4035 GRASS VALLEY HWY, STE KTELEPHONE:
(530) 885-0530
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:32CENSUS: 7DATE:
08/28/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Patricia PerezTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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2
3
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5
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7
8
9
Facility operating out of ratio.
Uncleared staff providing care and supervision to children in care.
INVESTIGATION FINDINGS:
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9
10
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13
On August 28th, 2025 Licensing Program Analysts (LPAs) Mandie Goodwin and Lea Habtom met Director Patricia Perez to close a complaint investigation regarding the above allegations. Upon arrival 7 preschool children were present supervised by 2 staff members.

LPAs made observations at facility on 8/28/25, 7/15/25, and 7/9/25. During inspections LPAs observed facility to be operating within ratio. LPAs observed criminal background checks for all staff that are currently providing care and supervision to children in care.

Although the alleged violations may have happened or are valid, the preponderance of evidence standard has not been met to fully prove or disprove that they did or did not occur, therefore, they are unsubstantiated. An exit interview was conducted and a notice of site visit provided. Notice of site visit shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20250702160050
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: O'BRIEN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 313620289
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/28/2025
Section Cited
CCR
101221(a)
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Child's Records: A separate, complete and current record for each child is maintained in the child care center. This requirement was not met as evidenced by: Based on interviews with the director there was some children that did not have files at the facility, including their emergency contact information.
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Director now has emergency cards for each child located in a central box that staff can access. Deficiency cleared at time of visit.
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This poses a potential health, safety, or personal rights risk to persons 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: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3