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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624646
Report Date: 08/02/2023
Date Signed: 08/02/2023 03:17:20 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
06/29/2023 and conducted by Evaluator Karyn Guerra
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230629093951
FACILITY NAME:CREEKSIDE PRESCHOOL & INFANT CENTERFACILITY NUMBER:
343624646
ADMINISTRATOR:MANLEY, ROBERTAFACILITY TYPE:
840
ADDRESS:2550 BELPORT LANETELEPHONE:
(916) 333-1169
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:15CENSUS: 5DATE:
08/02/2023
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Sharon SimmonsTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff are not providing appropriate supervision to children in care.
INVESTIGATION FINDINGS:
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At 12:45 p.m. on Wednesday, August 2nd, 2023, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Sharon Simmons, for the purpose of an unannounced complaint inspection to deliver findings. It was alleged that Staff are not providing appropriate supervision to children in care. Throughout the course of the investigation, LPA conducted interviews, made observations, and gathered documentation. LPA came to learn of an incident in which a child sustained a rope injury on their neck during outdoor play time. A teacher coming back from their break assisted the child while two other staff were stated to be supervising children on the play yard. LPA observed injury report documentation. Interviews with children did not reveal any supervision concerns. It was stated that staff will sit at a central bench during outdoor play time. Director stated that there have been regular trainings and reminders to all

report continued on 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
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-20230629093951
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: CREEKSIDE PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 343624646
VISIT DATE: 08/02/2023
NARRATIVE
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staff regarding supervision. LPA advised staff circulation of play yard during outdoor play time. Director stated that ropes will be at a designated outdoor location and staff are not supposed to be stationary outdoors. The allegation is unsubstantiated. Although the alleged violation may have happened or is valid, the preponderance of evidence standard has not been met to fully prove or disprove that the allegation did or did not occur, therefore, it is unsubstantiated. This report was reviewed with the Director, Sharon Simmons. A notice of site visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2