343624916-9-10-2024-03-CC-SDLA-DALL97-20241101083305

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343624916
Report Date: 09/10/2024
Date Signed: 09/10/2024 02:55:06 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
08/13/2024 and conducted by Evaluator Josiah Gathing

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20240813091032

FACILITY NAME:	MISSION AVENUE PRESCHOOL		FACILITY NUMBER:	343624916
ADMINISTRATOR:	CHRISTINA DIAZ BUSHMAN		FACILITY TYPE:	830
ADDRESS:	2433 MISSION AVENUE		TELEPHONE:	(916) 487-4647
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	19	CENSUS: 11	DATE:	09/10/2024
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Nicole Moran-Estrada		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Staff did not ensure infant's bottles are heated to a safe temperature.
Staff did not provide water or formula to infants in care.
Licensee allows unqualified staff to assist in infant room.

INVESTIGATION FINDINGS:

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On September 10, 2024 at approximately 11:30 AM Licensing Program Analyst (LPA) Josiah Gathing met with Director Nicole Moran-Estrada for the purpose of an unannounced complaint investigation to deliver findings for the above allegations. It was alleged that staff did not ensure infant's bottles are heated to a safe temperature, staff did not provide water or formula to infants in care, and licensee allows unqualified staff to assist in infant room. LPA reviewed infant staff files and found fully qualified teachers supervising infants at all times throughout the investigation. Staff stated in interview that milk and formula are heated in warmers to appropriate temperatures for infants. LPA observed a warmer and formula heated to a safe temperature. Parents stated in interview that the facility is sufficiently staffed. Staff and parents stated in interview that parents are called for pickup if infants are not eating.
Based on observation, record review, and interview, the alleged violations were found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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