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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624222
Report Date: 06/10/2024
Date Signed: 06/10/2024 01:56:27 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
04/23/2024 and conducted by Evaluator Jennifer Velasco
COMPLAINT CONTROL NUMBER: 03-CC-20240423091635
FACILITY NAME:KIDS INC PRESCHOOL & DISCOVERY CENTERFACILITY NUMBER:
343624222
ADMINISTRATOR:MEENAKSHI ROYFACILITY TYPE:
850
ADDRESS:405 NATOMA STATION DRIVETELEPHONE:
(916) 353-0300
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:93CENSUS: 60DATE:
06/10/2024
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Alex GrayTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Facility staff did not prevent inappropriate interaction between day care children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jennifer Velasco met with Facility Representative, Alex Gray (FR), for an unannounced complaint investigation inspection pertaining to the above allegation. The purpose of today's inspection was explained to FR. During this investigation, LPA conducted interviews, observed care, and obtained relevant documentation. Based on statements by multiple witnesses, facility staff failed to prevent inappropriate interaction between children in care. The preponderance of evidence standard has been met; therefore, the above allegation is substantiated. Facility Representative was informed that this report dated 06/10/2024 documents one Type A citation and must be posted for parental review for 30 consecutive days. The facility must also provide a copy of this licensing report 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 each child's file for verification. Exit interview was conducted and report was reviewed with Facility Representative, Alex Gray. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2024
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 2
Control Number 03-CC-20240423091635
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: KIDS INC PRESCHOOL & DISCOVERY CENTER
FACILITY NUMBER: 343624222
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/11/2024
Section Cited
CCR
101229(a)
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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement was not met as evidenced by: Based on multiple witness statements, LPA learned that
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Facility Representative (FR) stated the classroom has been rearranged to prevent blind spots so staff can visually supervise all children at all times. FR also stated staff have received additional training and additional observation and guidance from management in the facility.
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inappropriate incidents between children occurred due to lack of visual observation by staff. This was a self-reported incident. This poses an immediate threat to the health, safety, and/or personal rights of children in care.
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FR has provided LPA with documentation of the training and showed LPA the changes in the classroom. The POC has been met.
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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: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2024
LIC9099 (FAS) - (06/04)
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