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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393611645
Report Date: 08/29/2024
Date Signed: 01/06/2025 10:33:42 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
07/03/2024 and conducted by Evaluator Erwin Tjhia
COMPLAINT CONTROL NUMBER: 53-CC-20240703140031
FACILITY NAME:CAMP HUTCHINS OF LODI MEMORIAL HOSPITALFACILITY NUMBER:
393611645
ADMINISTRATOR:MARIA ZAMORAFACILITY TYPE:
850
ADDRESS:125 SOUTH HUTCHINS STREETTELEPHONE:
(209) 334-2267
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:53CENSUS: 22DATE:
08/29/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH: Karla Fuentes and Sandra JohnsonTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff yells at children in care
INVESTIGATION FINDINGS:
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**This is an amend version of a report originally signed on 08/29/2024.**
Licensing Program Analyst (LPA) Erwin Tjhia met with the Site Supervisor, Sandra Johnson, and the center director, Karla Fuentes to deliver findings of the complaint investigation regarding the above allegation.

Throughout the course of the investigation, LPA conducted interviews, observation, and obtained pertinent information. It was alleged that Staff yells at children in care. The interviews conducted revealed that staff #1 raised voice to the children, and on one occasion, used inappropriate word toward children and staff. During the interview, three out of nine children revealed that they were not feel comfortable around staff #1.

Report Continue on 809-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025
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 5
Control Number 53-CC-20240703140031
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CAMP HUTCHINS OF LODI MEMORIAL HOSPITAL
FACILITY NUMBER: 393611645
VISIT DATE: 08/29/2024
NARRATIVE
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Based on the interviews and observation the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The following Title 22 Deficiency is being cited on the subsequent 9099-D pages. Upon receipt of Type A citations, Director shall post and provide copies of the LIC 9099-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Director must also keep the signed LIC 9224, acknowledging receipt of LIC 9099-D in each child's file. Appeal Rights was provided and Notice of Site Visit was posted.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 53-CC-20240703140031
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CAMP HUTCHINS OF LODI MEMORIAL HOSPITAL
FACILITY NUMBER: 393611645
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2024
Section Cited
CCR
101223(a)(3)
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101223 Personal Rights (a)The licensee shall ensure that each child is accorded the following personal rights:…(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature …This regulation was not met as evidenced by:
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Facility will conduct a personal rights training to all staff, which will also include the CCLD video on Personal Rights and appropriate communication around children. https://ccld.childcarevideos.org/. Facility will send LPA staff signatures showing their attendance and understanding of the meeting.
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Interviews revealed that staff #1 raised voice to the children, and on one occasion, used inappropriate word toward children and staff. This poses an immediate health, safety, or personal rights risk to children in care.
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Deficiency Dismissed
Type A
08/30/2024
Section Cited
CCR
101516.5(b)(1)
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101516.5 (b)(1) A teacher shall supervise no more than 14 children or with an aide a maximum of 28 children.
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LPA will conduct follow up visit to verify compliance
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This requirement was not met as LPA observed one teacher supervised for more than 14 school age children in two different occasions (07/09/2024 and 08/01/2024) which is an immediate health and safety risk to children in care.
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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: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
07/03/2024 and conducted by Evaluator Erwin Tjhia
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240703140031

FACILITY NAME:CAMP HUTCHINS OF LODI MEMORIAL HOSPITALFACILITY NUMBER:
393611645
ADMINISTRATOR:MARIA ZAMORAFACILITY TYPE:
850
ADDRESS:125 SOUTH HUTCHINS STREETTELEPHONE:
(209) 334-2267
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:53CENSUS: DATE:
08/29/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Teresa Whitmire and Sandra JohnsonTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff does not ensure room temperature is properly maintained for children in care
Staff did not ensure children were provided food during meal time
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Erwin Tjhia met with the administrator, Teresa Whitmire, and Site Supervisor, Sandra Johnson to deliver findings of the complaint investigation regarding the above allegation.

Throughout the course of the investigation, LPA conducted interviews, observation, and obtained pertinent information. It was alleged that staff does not ensure room temperature is properly maintained for children in care. Interviews with staff revealed that the Air Conditioner in the room where the school age children were, stopped working. The interview revealed that the temperature in the room was at 84’F while the temperature outside was above 105’F which was less than 20’F different. LPA received conflicting stated during children interview. Some children stated that the room was cold, and a child stated that it was too warm, but was not too hot. Parents interviewed revealed that they were not aware of the incident and did not has any concern regarding the facility physical environment.

Report Continue on 809-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20240703140031
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CAMP HUTCHINS OF LODI MEMORIAL HOSPITAL
FACILITY NUMBER: 393611645
VISIT DATE: 08/29/2024
NARRATIVE
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Furthermore, it was alleged that staff did not ensure children were provided food during mealtime. LPA received a conflicting statement during the staff interview. Two out of nine staff interviewed stated the children eat only during the snack or lunch time. The rest of the staff stated that children were never been denied for food and drink during mealtime. Some staff stated that children could eat and drink whenever they want to especially the children that brought their own meal from home. Interview with parents revealed that they did not has any concern regarding this. One parent stated that she saw children eat and drink during the meal time. Interview with children revealed that they all eat and drink during meal time. The children also stated that teacher and staff never denied them for food or drink.

Based on the information obtained throughout the course of this investigation the above allegations, LPA Tjhia determined that the allegations were found to be UNSUBSTANTIATED, meaning although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.



Exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5