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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624247
Report Date: 04/02/2025
Date Signed: 04/02/2025 02:13:54 PM

Unsubstantiated


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
02/14/2025 and conducted by Evaluator Erwina Pascual-Golamco
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250214133430
FACILITY NAME:EXCELSIOR PRESCHOOL GOLD RIVER LLCFACILITY NUMBER:
343624247
ADMINISTRATOR:INGRAM, MICHELLEFACILITY TYPE:
850
ADDRESS:2317 GOLD MEADOW WAYTELEPHONE:
(916) 730-8757
CITY:GOLD RIVERSTATE: CAZIP CODE:
95670
CAPACITY:118CENSUS: 46DATE:
04/02/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Michelle IngramTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not provide adequate supervision to children in care
Facility is not kept clean
INVESTIGATION FINDINGS:
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Licensing Program Analyst Erwina Pascual-Golamco (LPA) met with Facility Representative, Michelle Ingram (FR), to deliver findings. LPA toured the facility, including all activity and classroom spaces, and outdoor play areas. FR was reminded never to exceed the conditions, limitations, and capacity specified on the license.

It was alleged that Staff did not provide adequate supervision to children in care and Facility is not kept clean. Throughout the course of the investigation, LPA toured the facility, observed staff provide care to children, and conducted staff and parent interviews. Interviews revealed that staff do a name to face, and walk around when children have indoor and outdoor activities. Staff are spread out throughout the playground to supervise all areas. Interviews revealed that the facility went through a transition stage, and they are still adjusting to the change. Parent/Guardian concerns were staff turnovers, but have not observed supervision issues. Continued on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
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-20250214133430
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: EXCELSIOR PRESCHOOL GOLD RIVER LLC
FACILITY NUMBER: 343624247
VISIT DATE: 04/02/2025
NARRATIVE
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Staff wipe down their classroom tables and sweep floors after every activity, and they have a janitorial service that come nightly after facility hours to mop, vacuum, take out the trash, and clean the bathrooms throughout the facility. LPA Interviews, and observation failed to corroborate the allegation that Staff did not provide adequate supervision to children in care and Facility is not kept clean. Although the alleged violation may have happened or are valid, the preponderance of evidence standard has not been met to fully prove or disprove that it did or did not occur, therefore, it is UNSUBSTANTIATED.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2