<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483009177
Report Date: 12/09/2021
Date Signed: 12/09/2021 12:06:02 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/08/2021 and conducted by Evaluator Carrie Wisehart
COMPLAINT CONTROL NUMBER: 13-CC-20211208085524
FACILITY NAME:FATHER'S KIDS PRESCHOOL, THEFACILITY NUMBER:
483009177
ADMINISTRATOR:CONNOR, PAMELAFACILITY TYPE:
850
ADDRESS:4800 HORSE CREEK DRIVETELEPHONE:
(707) 455-7790
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY:120CENSUS: 45DATE:
12/09/2021
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Tammi Stout, Assist Director and Pamela ConnerTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not following the terms of the admission agreement
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
The unannounced facility inspection was conducted by Licensing Program Analyst, Wisehart. It has been alleged that the facility was not following the terms of the admission agreement because a child was placed in the pre-kindergarten class though the child did not meet the age requirement outlined on the admissions agreement.

LPA met with the Director and discussed the allegation and conducted interviews The director stated that C1 was placed in the 4-5 YOA class at the request of the parent because that is the only 5 day a week class available and the parent wanted a 5 day plan. The director acknowledges that the conversation with the responsible party was verbal and that no admission agreement addendum was reviewed and/or signed with C1's responsible party.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
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 3
Control Number 13-CC-20211208085524
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: FATHER'S KIDS PRESCHOOL, THE
FACILITY NUMBER: 483009177
VISIT DATE: 12/09/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The LPA interviewed 1 out of 1 staff (S1) who indicated that the parent had asked that the child attend a 5 day a week plan and so the staff accommodated the request.

The LPA interviewed 1 out of 1 witness who indicated that C1 was only 3 YOA but was placed in a class for 4-5 YOA without her consent which is against the admission agreement policies.

The LPA reviewed documents and observed that C1 was not 4 YOA on or before Sept 1, 2018 which per the signed admission agreement is the age to be enrolled in the Pre-kindergarten class. However, the LPA did observed that the child did turn 4 YOA later the same month. The LPA also observed that no written admission agreement addendums were reviewed and/or signed by the school and C1's responsible party waiving the classroom age requirements.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated.
Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20211208085524
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: FATHER'S KIDS PRESCHOOL, THE
FACILITY NUMBER: 483009177
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/09/2021
Section Cited
CCR
101219(d)
1
2
3
4
5
6
7
Admissions Agreement 101219 (d)
Modifications to the original admission agreement shall be made whenever circumstances covered in the agreement change, and shall be dated and signed by the persons specified in
1
2
3
4
5
6
7
The director agrees to come up an admissions agreement addendum page to be reviewed and signed and kept in the child's file whenever agreement changes are agreed upon with the families. This agreement addendum was submitted at the time of visit. No further actions required.

8
9
10
11
12
13
14
This requirement was not met as evidenced by: Based on interviews and record review that C1's admission agreement was modified and the child was placed in a higher age group based on verbal discussion but with no signed/written addendum to the agreement. This poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3