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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 053613073
Report Date: 11/04/2021
Date Signed: 11/04/2021 11:12:13 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/21/2021 and conducted by Evaluator Chayntel Hunter
COMPLAINT CONTROL NUMBER: 53-CC-20210921084538
FACILITY NAME:GARANT, MICHELLEFACILITY NUMBER:
053613073
ADMINISTRATOR:GARANT, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 772-7267
CITY:VALLEY SPRINGSSTATE: CAZIP CODE:
95252
CAPACITY:14CENSUS: 5DATE:
11/04/2021
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Licensee, Michelle GarantTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Neglect/Lack of Supervision: Licensee did not provide adequate supervision resulting in child wandering from the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Chayntel Hunter and Christopher Jackson met with Licensee, Michelle Garant to deliver the findings of the complaint investigation regarding the above allegation.

During the course of the investigation, LPA Hunter conducted interviews, and obtained information pertaining to allegation. It was alleged that the Licensee did not provide adequate supervision resulting in a child (C1) wandering from the facility. Licensee stated that a child had wandered from the facility but stated that the child only made it to bottom of the Licensee's driveway. Licensee stated that herself and staff had eyes on the child the entire time and that the assistant ran after C1 and brought C1 back up the driveway to the facility. However, interviews conducted revealed that C1 wandered from the facility and was found by another adult (A1), approximately 900 feet away from the facility. A3 stated that the Licensee told A3 that C1 was found by a neighbor due to the Licensee's alarm not working.

Report continues on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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 53-CC-20210921084538
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: GARANT, MICHELLE
FACILITY NUMBER: 053613073
VISIT DATE: 11/04/2021
NARRATIVE
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The Licensee stated she was unaware of other adults being involved in the incident. When the Licensee’s assistant was asked if other adults were present, the assistant stated No. Interviews conducted revealed that there were other parties involved.

Based on the interviews conducted and documents obtained, 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, Licensee 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. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 9099-D in each child's file.



An exit interview was conducted with the Licensee. Appeal rights were printed and provided. Notice of Site Visit was provided and should remain posted for 30 days.
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 53-CC-20210921084538
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: GARANT, MICHELLE
FACILITY NUMBER: 053613073
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/05/2021
Section Cited
CCR
102417(a)
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102147 Operation of a Family Child Care Home. (a) The licensee shall be present... and shall ensure that children in care are supervised at all times. This requirement was not met as evidenced by:
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Licensee stated she has installed an alarm on the front door and has placed child proof door knob covers on the front door, to ensure there are no future occurences.
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Based on interviews conducted and record reviews, it was determined that C1 had wandered approximately 900 feet away from the facility, and was found by A1 and A2. This is an immediate health and safety risk to children in care.
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IMMEDIATE CIVIL PENALTY IN THE AMOUNT OF $500.00 IS ASSESSED.
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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.
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3