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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313623221
Report Date: 02/10/2022
Date Signed: 02/10/2022 09:58:43 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/04/2022 and conducted by Evaluator Katrina Owens
COMPLAINT CONTROL NUMBER: 03-CC-20220204141937
FACILITY NAME:FREDERICK, HEATHERFACILITY NUMBER:
313623221
ADMINISTRATOR:FREDERICK, HEATHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 508-2448
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:14CENSUS: 9DATE:
02/10/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Heather Frederick - LicenseeTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
OTHER: Staff did not allow child's authorized representative to view child's file
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced inspection is conducted today by Licensing Program Analyst Owens. LPA Owens met with licensee, Heather Frederick. Present at time of inspection was licensee, her assistant and 9 day care children.

The purpose of the inspection is to close a complaint investigation that was originally opened on February 8, 2022. Based on interviews and other documents, licensee did not respond to a child's authorized representative request of child's file. Therefore, the preponderance of evidence was met and the above allegation is found to be Substantiated. As a result of the findings, A Technical Advisory note, LIS9102-Technical Violation was issued. Appeals Rights were given to the licensee at time of inspection.
A Notice of site visit given and must be posted for 30 days.


Therefore the above allegation is substantiated.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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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