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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313622152
Report Date: 10/03/2024
Date Signed: 10/03/2024 12:23:38 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
10/02/2024 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20241002091747
FACILITY NAME:LITTLE SUNSHINE'S PLAYHOUSE & PS - GRANITE BAYFACILITY NUMBER:
313622152
ADMINISTRATOR:MARCI PILGRIMFACILITY TYPE:
830
ADDRESS:5370 DOUGLAS BLVDTELEPHONE:
(916) 605-0217
CITY:GRANITE BAYSTATE: CAZIP CODE:
95746
CAPACITY:48CENSUS: 27DATE:
10/03/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Marci PilgrimTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility is not providing a safe environment to children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Marci Pilgrim to conduct a complaint investigation. LPA observed 27 supervised by nine staff.
The following was alleged: Facility is not providing a safe environment for children in care.
During the investigation, LPA conducted interviews with witnesses and reviewed Child 1’s file. During file review, LPA observed that there were 29 documented biting incidents from Child 1, occurring between March to September 2024. There was documentation and evidence of Child 1 biting other children multiple times in the same day. Photos of injuries were also observed during the investigation. As of this date, there has not been a plan put in place to address/prevent the biting ensure the safety of all children in care.
The preponderance of evidence standard has been met; therefore, the allegation is determined to be SUBSTANTIATED.
Title 22 deficiencies are cited on the subsequent page of this report. If not corrected, these violations pose an immediate risk to the health and safety of children in care.
Continued...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
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 3
Control Number 03-CC-20241002091747
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: LITTLE SUNSHINE'S PLAYHOUSE & PS - GRANITE BAY
FACILITY NUMBER: 313622152
VISIT DATE: 10/03/2024
NARRATIVE
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LPA Jeremey McClain informed facility representative Marci Pilgrim that this report dated 10/03/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Also, LPA Jeremey McClain informed facility representative Marci Pilgrim to provide a copy of this licensing report dated 10/3/2024 that documents any Type A citations 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.

Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA provided appeal rights to facility representative.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20241002091747
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: LITTLE SUNSHINE'S PLAYHOUSE & PS - GRANITE BAY
FACILITY NUMBER: 313622152
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/07/2024
Section Cited
CCR
101223(a)(2)(3)
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Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights: (2)To be accorded safe, healthful and comfortable accommodations... (3)To be free from ..., infliction of pain, humiliation, intimidation... This requirement was not met as evidenced
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Facility representative stated that a behavior modification plan will be set in place to address Child 1's behavior. Child 1 will not be in attendance until a meeting with the parents has occurred and the behavior modification plan has been agreed to. Another offense will result in

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gathered during the investigation shows that the facility failed to address continuing biting from Child 1, which posed/poses an immediate risk to the health and safety of children in care. This was corroborated by LPAs interviews with witnesses, file review, and documented evidence.
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the child being sent home, a repeated offesne will result in the child being kept home for two days. A third offense will result in termination of services. Moving forward facility plans to address these types of situations sooner in order o prevent the behavior from escalating. Proof of the meeting and behavior modification plan shall be sent to LPA by 10/07/2024.
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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: Natalie Dunaway
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3