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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623950
Report Date: 08/05/2022
Date Signed: 08/05/2022 04:05:02 PM

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
06/20/2022 and conducted by Evaluator Lea Habtom
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220620152845
FACILITY NAME:TOTS OF LOVE - CITRUS HEIGHTSFACILITY NUMBER:
343623950
ADMINISTRATOR:COURTNEY WILLIAMSFACILITY TYPE:
830
ADDRESS:7312 ANTELOPE RDTELEPHONE:
(916) 560-9699
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:12CENSUS: 5DATE:
08/05/2022
ANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Dawnika GallegosTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Day-care child sustained an injury while in care
INVESTIGATION FINDINGS:
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On August 5, 2022 Licensing Program Analyst Lea Habtom met with designated staff Dawnika Gallegos to deliver the findings for the above allegation. During today’s visit there was a census of 5 infants being supervised by 2 staff.

During the investigation, LPA Habtom toured the facility, conducted observation and interviewed those pertinent to the investigation. It was alleged that staff did not provide adequate supervision to prevent a day-care child from sustaining an injury while in care. Interviews revealed that a child took a nap and woke up with a mark on the face with what looked like a bite mark. Staff were unable to provide an explanation on how the child got the mark but were able to confirm the child did not have the mark on the face prior to nap time. Staff documented the possible bite mark on the communication application to the parent on the day of the incident. Based on the corroborating statements taken the department has found that the allegation that a day-care child sustained an injury while in care due to a lack of supervision to be to be SUBSTANTIATED: meaning that the allegation is valid because the preponderance of the evidence standard has been met.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.







Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
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 03-CC-20220620152845
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: TOTS OF LOVE - CITRUS HEIGHTS
FACILITY NUMBER: 343623950
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/08/2022
Section Cited
CCR
101429(2)(A)
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101429(2)(A)Responsibility for providing care:
Sleeping infant(s) shall be directly observed by sight and sound at all times. This shall include when the infants are going to sleep, are sleeping, or are in the process of waking up.

This requirement was not met as evidenced by:
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they will do wellness checks prior to arrival and throughout the day as well as check the infants during nap time.
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A child got a mark on the face which looks like a bite mark after waking up from nap time. Staff confirmed child did not have the mark on the face prior to nap time and also documented the incident on the communication application. This poses an immediate danger to children in care if not corrected.
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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: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC9099 (FAS) - (06/04)
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