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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343604948
Report Date: 06/19/2024
Date Signed: 07/05/2024 12:41:39 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
06/17/2024 and conducted by Evaluator Katy Velazquez
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240617151022
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
343604948
ADMINISTRATOR:ROBERTS, DONYALEFACILITY TYPE:
850
ADDRESS:7901 LAGUNA BOULEVARDTELEPHONE:
(916) 691-3800
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:95CENSUS: 26DATE:
06/19/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Junita BelenTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff handled day care child in a rough manner
INVESTIGATION FINDINGS:
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This is an amended version of the original report dated 06/19/2024.
On 06/19/2023, Licensing Program Analyst Katy Velazquez (LPA) conducted an unannounced complaint investigation. LPA met with Assistant Director Juanita Belen (D1). LPA conducted a physical plant inspection, conducted staff interviews, reviewed and collected documentation. It was alleged that a staff member handled a day-care child in a rough manner. Interviews and documentation reveal that on 06/12/2024, a child was aggresively grabbed and moved in a shaking motion by a staff member (S1).
Based on interviews and file reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A Type-A deficiency was cited on a subsequent 9099-D page. D1 acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
CONTINUED ON 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
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 53-CC-20240617151022
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 343604948
VISIT DATE: 06/19/2024
NARRATIVE
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LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. An exit interview was conducted, and the report was reviewed with Assistant Director Belen. LPA provided Licensee Appeal Rights to D1. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20240617151022
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 343604948
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/20/2024
Section Cited
CCR
101223(a)(1)
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Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights:...(1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by S1 grabbing and shaking a day-care child
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Licensee will ensure that S1 receives training in Personal Rights, which will include the CCLD video "Children's Personal Rights in Child Care."
Licensee will email LPA and include details on what the training will entail and the date in which the training will occur by
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on 06/12/2024. This poses/posed a risk to the health, safety, and personal rights of person(s) in care.
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5 pm on 06/20/2024.
When S1 completes the training, Licensee will ensure that a signed statement is in S1's file aknowledging that S1 completed the training.
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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: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3